Mountain Medical Physician Specialists of Idaho PC
NPI 1053597237 · Diagnostic Radiology Physician · Burley, ID
Mountain Medical Physician Specialists of Idaho PC is a Diagnostic Radiology Physician organization in Burley, ID (NPI 1053597237).
Provider details
- NPI number
- 1053597237
- Entity type
- Organization
- Primary specialty
- Diagnostic Radiology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Clark Davis, Ceo(801) 284-1705
- License
- C176456 (ID)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2008-01-17
- Last updated
- 2008-11-12
Frequently asked questions
- What is Mountain Medical Physician Specialists of Idaho PC's NPI number?
- Mountain Medical Physician Specialists of Idaho PC's National Provider Identifier (NPI) is 1053597237, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Mountain Medical Physician Specialists of Idaho PC?
- Mountain Medical Physician Specialists of Idaho PC is classified in the NPPES registry as Diagnostic Radiology Physician (Allopathic & Osteopathic Physicians).
- Where is Mountain Medical Physician Specialists of Idaho PC located?
- Mountain Medical Physician Specialists of Idaho PC's practice location on file with NPPES is 1501 Hiland Ave, Burley, ID 83318-2682.
- What is Mountain Medical Physician Specialists of Idaho PC's phone number?
- The practice phone number listed in the NPPES registry for Mountain Medical Physician Specialists of Idaho PC is (801) 284-1755.
- Who is the authorized official for Mountain Medical Physician Specialists of Idaho PC?
- The authorized official listed on Mountain Medical Physician Specialists of Idaho PC's NPPES record is Clark Davis, Ceo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Mountain Medical Physician Specialists of Idaho PC's NPI active?
- Yes — Mountain Medical Physician Specialists of Idaho PC's NPI (1053597237) is active in the NPPES registry as of the last update on 2008-11-12.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.