ST LUKES REGIONAL MED CTR DBA ST LUKES PEDIATRIC SURGERY OF IDAHO is a pediatric surgery surgery in Boise, ID. The provider is a surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. ST LUKES REGIONAL MED CTR DBA ST LUKES PEDIATRIC SURGERY OF IDAHO NPI is 1720204738. The provider is registered as an organization entity type and is a single specialty group.
The provider's business location address is:
100 E IDAHO ST
SUITE 300
BOISE, ID
ZIP 83712-223
Phone: (208) 345-5400
Fax: (208) 345-5454
The provider's authorized official is Carrie L Cowgill .
The authorized official title is Credentialing Coordinator and has the following contact phone number (208) 381-4137.
The enumeration date for this NPI number is 4/18/2007 and was last updated on 4/9/2008.