EASTERN IDAHO REG MED CTR PS LLC NPI 1053352427

NPI Information

  • NPI: 1053352427
  • Provider Name: EASTERN IDAHO REG MED CTR PS, LLC
  • Classification: Obstetrics & Gynecology - 207VX0201X
  • Specialization: Gynecologic Oncology
  • Entity Type: Organization
  • Address: 3100 CHANNING WAY
    IDAHO FALLS, ID
    ZIP 83404
  • Phone: (208) 529-7147

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NPI Details

EASTERN IDAHO REG MED CTR PS, LLC is a gynecologic oncology obstetrics gynecology in Idaho Falls, ID. The provider is an obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications. EASTERN IDAHO REG MED CTR PS, LLC NPI is 1053352427. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

3100 CHANNING WAY
IDAHO FALLS, ID
ZIP 83404-533
Phone: (208) 529-7147

The provider's authorized official is Robert England .
The authorized official title is Vp and has the following contact phone number (208) 529-7147.

The enumeration date for this NPI number is 6/9/2006 and was last updated on 8/28/2007.

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
1207VX0201XObstetrics & GynecologyGynecologic OncologyYes

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
18L006OTHERIDAHOBLUE CROSS OF IDAHO
21378539MEDICARE ID-TYPE UNSPECIFIEDIDAHO

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: 11/21/2025

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