Edward a Desano Jr MD PA

NPI #1821127077 in Pocatello, Idaho

Provider Information

NPI Number: 1821127077
Entity Type: Organization
Organization Name: Edward a Desano Jr MD PA
Primary Specialty: Obstetrics & Gynecology
Enumeration Date: Mar 5, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 755 HOSPITAL WAY
Address 2: B 2
City: Pocatello
State: Idaho
ZIP Code: 83201-2717
Phone: (208) 232-0581

Authorized Official

Name: MARSHA DESANO
Title: OFFICE MANAGER
Phone: (208) 251-6690

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Obstetrics & Gynecology	207V00000X	Primary

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