SOUTHERN IDAHO PAIN INSTITUTE P.C. NPI 1336240670

NPI Information

SOUTHERN IDAHO PAIN INSTITUTE P.C. is an ambulatory surgical clinic center in Twin Falls, ID. SOUTHERN IDAHO PAIN INSTITUTE P.C. NPI is 1336240670. The provider is registered as an organization entity type.

The provider's business location address is:

236 MARTIN ST.
TWIN FALLS, ID
ZIP 83301
Phone: (208) 733-3181
Fax: (208) 733-3168

The provider's authorized official is Clinton L. Dille .
The authorized official title is Owner/anesthesiologist and has the following contact phone number (208) 733-3181.

The CLIA number assigned to this NPI record is 13D1105419 - other practitioner with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 9/26/2006 and was last updated on 2/26/2010.

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:

Other Identifiers

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

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