| St Lukes Woodriver Internal Medicine | |
|
100 Hospital Drive Ketchum ID 83340 | |
| (208) 788-2222 | |
| Not Available |
| Full Name | St Lukes Woodriver Internal Medicine |
|---|---|
| Speciality | Internal Medicine |
| Location | 100 Hospital Drive, Ketchum, Idaho |
| Authorized Official Name and Position | Bruce Jensen (DIRECTOR) |
| Authorized Official Contact | 2087278401 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St Lukes Woodriver Internal Medicine Po Box 1098 Boise ID 83701-1098 Ph: (208) 381-2222 | St Lukes Woodriver Internal Medicine 100 Hospital Drive Ketchum ID 83340 Ph: (208) 788-2222 |
| NPI Number | 1841343720 |
|---|---|
| Provider Enumeration Date | 01/22/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841343720 | NPI | - | NPPES |
| 62 | Other | ID | HOSPITAL STATE LICENSE # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 62 (Idaho) | Primary |
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