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SNAKE RIVER EAR NOSE & THROAT PC NPI 1104912740


NPI Information

NPI: 1104912740
Provider Name: SNAKE RIVER EAR, NOSE & THROAT PC
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
706 NORTH COLLEGE ROAD
SUITE C
TWIN FALLS, ID
ZIP 83301
Phone: (208) 735-1000
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SNAKE RIVER EAR, NOSE & THROAT PC is a specialist in Twin Falls, ID. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. SNAKE RIVER EAR, NOSE & THROAT PC NPI is 1104912740. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

706 NORTH COLLEGE ROAD
SUITE C
TWIN FALLS, ID
ZIP 83301
Phone: (208) 735-1000
Fax: (208) 732-5345

The provider's authorized official is Rod Kack .
The authorized official title is Owner and has the following contact phone number (208) 735-1000.

The enumeration date for this NPI number is 10/4/2006 and was last updated on 1/15/2013.


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
1174400000XSpecialistA89785IDAHOYes

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
1=========OTHERIDAHOTAX ID
2A51210MEDICARE UPINIDAHO
3805168100MEDICAIDIDAHO
4A89785MEDICARE UPINIDAHO
51377791MEDICARE PINIDAHO

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

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