Southern Idaho Surgery Center Pllc

NPI #1396069902 in Meridian, Idaho

Provider Information

NPI Number: 1396069902
Entity Type: Organization
Organization Name: Southern Idaho Surgery Center Pllc
Primary Specialty: Clinic/Center - Ambulatory Surgical
Enumeration Date: Mar 25, 2010
Last Updated: Jul 9, 2012

Practice Location

Address: 3235 N TOWERBRIDGE WAY STE 100
City: Meridian
State: Idaho
ZIP Code: 83646-5721
Phone: (208) 895-6611

Authorized Official

Name: DR. MARLON B MICHEL, MD
Title: PRESIDENT
Phone: (208) 895-6611

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Ambulatory Surgical — Ambulatory Surgical	261QA1903X	Primary

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