Blue Lakes Gastroenterology, Pllc

NPI #1144267022 in Twin Falls, Idaho

Provider Information

NPI Number
1144267022
Entity Type
Organization
Organization Name
Blue Lakes Gastroenterology, Pllc
Primary Specialty
Internal Medicine - Gastroenterology
Enumeration Date
Jun 1, 2006
Last Updated
Mar 9, 2013

Practice Location

Address
775 POLE LINE RD W
Address 2
SUITE 203
State
Idaho
ZIP Code
83301-5814
Phone
(208) 814-8300

Authorized Official

Name
ROBERT WARD, M.D.
Title
PHYSICIAN
Phone
(208) 814-8300

Specialties & Taxonomy Codes

Specialty
Internal Medicine - GastroenterologyGastroenterology

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