Portneuf Medical Center

NPI #1578505335 in Pocatello, Idaho

Provider Information

NPI Number: 1578505335
Entity Type: Organization
Organization Name: Portneuf Medical Center
Primary Specialty: Clinic/Center
Enumeration Date: Jun 12, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 651 MEMORIAL DR
City: Pocatello
State: Idaho
ZIP Code: 83201-4071
Phone: (208) 282-4700

Authorized Official

Name: JOHNATHAN WILKER
Title: VP FINANCE & CFO
Phone: (208) 239-1020

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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