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ST JOSEPHS EAR NOSE AND THROAT CLINIC PLLC NPI 1952355539


NPI Information

NPI: 1952355539
Provider Name: ST JOSEPHS EAR NOSE AND THROAT CLINIC PLLC
Classification: Specialist - 174400000X
Entity Type: Organization

CLIA Number: 13D2173910

Address:
323 N SPOKANE ST
STE 100
POST FALLS, ID
ZIP 83854
Phone: (208) 777-1320
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ST JOSEPHS EAR NOSE AND THROAT CLINIC PLLC is a specialist in Post 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. ST JOSEPHS EAR NOSE AND THROAT CLINIC PLLC NPI is 1952355539. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

323 N SPOKANE ST
STE 100
POST FALLS, ID
ZIP 83854-513
Phone: (208) 777-1320
Fax: (208) 777-1322

The provider's authorized official is Thomas R Detar .
The authorized official title is Owner/member and has the following contact phone number (208) 777-1320.

The CLIA number assigned to this NPI record is 13D2173910 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/19/2006 and was last updated on 9/3/2020.


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
1174400000XSpecialistYes

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
1151513OTHERIDAHOWASHINGTON L&I
28M012OTHERIDAHOBLUE CROSS OF IDAHO
37087273MEDICAIDIDAHO
4805084300MEDICAIDIDAHO
58938054OTHERIDAHOWA L&I CRIME VICTIMS
60000100006619OTHERIDAHOREGENCE/ASURIS

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.