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DIGESTIVE HEALTH CLINIC LLC NPI 1750498333


NPI Information

NPI: 1750498333
Provider Name: DIGESTIVE HEALTH CLINIC LLC
Classification: Internal Medicine - 207RG0100X
Entity Type: Organization

Specialization: Gastroenterology

CLIA Number: 13D0521878

Address:
6259 W EMERALD ST
BOISE, ID
ZIP 83704
Phone: (208) 489-1900
Get Directions

DIGESTIVE HEALTH CLINIC LLC is a gastroenterology internal medicine in Boise, ID. The provider is an internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. DIGESTIVE HEALTH CLINIC LLC NPI is 1750498333. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

6259 W EMERALD ST
BOISE, ID
ZIP 83704-731
Phone: (208) 489-1900
Fax: (208) 375-5286

The provider's authorized official is Mark A Mallory .
The authorized official title is Manager and has the following contact phone number (208) 489-1900.

The CLIA number assigned to this NPI record is 13D0521878 - independent with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 8/23/2006 and was last updated on 7/24/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RG0100XInternal MedicineGastroenterologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1807631700MEDICAIDIDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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