Premier Emergency Physicians of Idaho Medical Group

NPI #1336223379 in Kellogg, Idaho

Provider Information

NPI Number: 1336223379
Entity Type: Organization
Organization Name: Premier Emergency Physicians of Idaho Medical Group
Primary Specialty: Emergency Medicine
Enumeration Date: Oct 25, 2006
Last Updated: Mar 24, 2008

Practice Location

Address: 3 JACOBS GULCH RD
City: Kellogg
State: Idaho
ZIP Code: 83837-2023
Phone: (208) 784-1221

Authorized Official

Name: DR. JOSEPH H. GATEWOOD, MD
Title: PRESIDENT PREMIER EMERENCY PHYSICIA
Phone: (800) 444-7009

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Emergency Medicine	207P00000X	Primary

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