St Lukes Regional Medical Center

NPI #1053624759 in Boise, Idaho

Provider Information

NPI Number: 1053624759
Entity Type: Organization
Organization Name: St Lukes Regional Medical Center
Subpart: Yes (part of a larger organization)
Parent Organization: ST LUKES REGIONAL MEDICAL CENTER
Primary Specialty: Family Medicine
Enumeration Date: Jul 22, 2010
Last Updated: Jul 22, 2010

Practice Location

Address: 1520 W STATE ST
Address 2: STE 100
City: Boise
State: Idaho
ZIP Code: 83702-4085
Phone: (208) 947-7700

Authorized Official

Name: JOHN KEE
Title: VP PHYSICIAN SERVICES
Phone: (208) 381-5329

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X
Pediatrics	208000000X
Family Medicine	207Q00000X	Primary

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