Upper Valley Pediatrics

NPI #1588724744 in Rexburg, Idaho

Provider Information

NPI Number: 1588724744
Entity Type: Organization
Organization Name: Upper Valley Pediatrics
Primary Specialty: Pediatrics
Enumeration Date: Dec 11, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 36 PROFESSIONAL PLAZA
City: Rexburg
State: Idaho
ZIP Code: 83440
Phone: (208) 356-0234

Authorized Official

Name: MR. GENE PRESTON GATES, M.D.
Title: MANAGING PARTNER
Phone: (208) 356-0234

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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