SURGICAL ASSOCIATES OF SOUTHERN ID NPI 1033259700

NPI Information

NPI: 1033259700
Provider Name: SURGICAL ASSOCIATES OF SOUTHERN ID
Classification: Physician Assistant - 363AS0400X
Entity Type: Organization

Specialization: Surgical

Address:
650 ADDISON AVE W
TWIN FALLS, ID
ZIP 83301
Phone: (208) 737-2112
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SURGICAL ASSOCIATES OF SOUTHERN ID is a surgical physician assistant in Twin Falls, ID. SURGICAL ASSOCIATES OF SOUTHERN ID NPI is 1033259700. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

650 ADDISON AVE W
TWIN FALLS, ID
ZIP 83301-444
Phone: (208) 737-2112

The provider's authorized official is Scott Schrader .
The authorized official title is President and has the following contact phone number (208) 736-4568.

The enumeration date for this NPI number is 2/8/2007 and was last updated on 1/15/2010.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AS0400X	Physician Assistant	Surgical	PA271	IDAHO	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	PAWT9	OTHER	IDAHO	BLUE CROSS
2	000010151672	OTHER	IDAHO	BLUE SHIELD
3	805592000	MEDICAID	IDAHO
4	1379299	MEDICARE PIN	IDAHO

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: 11/14/2023

NPI Synchronization or Removal

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