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EDWARD A DESANO JR MD PA NPI 1821127077


NPI Information

NPI: 1821127077
Provider Name: EDWARD A DESANO JR MD PA
Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Organization
Address:
755 HOSPITAL WAY
B 2
POCATELLO, ID
ZIP 83201
Phone: (208) 232-0581
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EDWARD A DESANO JR MD PA is an obstetrics gynecology in Pocatello, ID. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. EDWARD A DESANO JR MD PA NPI is 1821127077. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

755 HOSPITAL WAY
B 2
POCATELLO, ID
ZIP 83201-717
Phone: (208) 232-0581

The provider's authorized official is Marsha Desano .
The authorized official title is Office Manager and has the following contact phone number (208) 251-6690.

The enumeration date for this NPI number is 3/5/2007 and was last updated on 8/22/2020.


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
1207V00000XObstetrics & GynecologyM-3307IDAHOYes

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
10002460200MEDICAIDIDAHO

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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