St Luke's Regional Medical Center

NPI #1306149919 in Meridian, Idaho

Provider Information

NPI Number: 1306149919
Entity Type: Organization
Organization Name: St Luke's Regional Medical Center
Subpart: Yes (part of a larger organization)
Parent Organization: ST LUKE'S REGIONAL MEDICAL CENTER
Primary Specialty: Family Medicine
Enumeration Date: Dec 21, 2010
Last Updated: Dec 21, 2010

Practice Location

Address: 3090 E GENTRY WAY
Address 2: STE 200
City: Meridian
State: Idaho
ZIP Code: 83642-3501
Phone: (208) 887-6813

Authorized Official

Name: JEFF TAYLOR
Title: SYSTEM VP CFO
Phone: (208) 381-2520

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Nurse Practitioner	363L00000X
Family Medicine	207Q00000X	Primary

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