Southeast Idaho Gastroenterology, Pllc

NPI #1780867457 in Pocatello, Idaho

Provider Information

NPI Number
1780867457
Entity Type
Organization
Organization Name
Southeast Idaho Gastroenterology, Pllc
Primary Specialty
Physician Assistant - Medical
Enumeration Date
Dec 17, 2007
Last Updated
Dec 17, 2007

Practice Location

Address
1151 HOSPITAL WAY STE A
State
Idaho
ZIP Code
83201-5091
Phone
(208) 232-6616

Authorized Official

Name
DEBBIE J FERREL
Title
PRACTICE MANAGER
Phone
(208) 232-6616

Specialties & Taxonomy Codes

Specialty
Physician Assistant - MedicalMedical

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