Grand Teton Gastroenterology, PA
NPI #1154390938 in Idaho Falls, Idaho
Provider Information
- NPI Number
- 1154390938
- Entity Type
- Organization
- Organization Name
- Grand Teton Gastroenterology, PA
- Primary Specialty
- Internal Medicine - Gastroenterology
- Enumeration Date
- Mar 15, 2006
- Last Updated
- Jun 7, 2010
Practice Location
- Address
- 2770 CORTEZ AVE
- City
- Idaho Falls
- State
- Idaho
- ZIP Code
- 83404-7590
- Phone
- (208) 522-4000
Authorized Official
- Name
- MRS. MELISSA DAWN LEMONS, CCS-P
- Title
- BILLING SUPERVISOR
- Phone
- (208) 528-4255
Specialties & Taxonomy Codes
| Specialty |
|---|
| Internal Medicine - Gastroenterology — Gastroenterology |
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