Blackfoot Medical Clinic Surgeons

NPI #1740580794 in Blackfoot, Idaho

Provider Information

NPI Number: 1740580794
Entity Type: Organization
Organization Name: Blackfoot Medical Clinic Surgeons
Subpart: Yes (part of a larger organization)
Parent Organization: BLACKFOOT MEDICAL CLINIC INC
Primary Specialty: Surgery
Enumeration Date: Oct 25, 2010
Last Updated: Oct 25, 2010

Practice Location

Address: 1441 PARKWAY DR
City: Blackfoot
State: Idaho
ZIP Code: 83221-1667
Phone: (208) 785-2600

Authorized Official

Name: KERRY CASPERSON
Title: ADMINISTRATOR
Phone: (208) 785-2600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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