OrganizationActive
Pocatello Pulmonary PC
NPI 1497766240 · Pulmonary Disease Physician · Pocatello, ID
Provider details
- NPI number
- 1497766240
- Entity type
- Organization
- Primary specialty
- Pulmonary Disease PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Cary Jackson, President(208) 233-5864
- License
- M5647 (ID)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
500 S 11th Ave
Suite 305
Pocatello, ID 83201-4835
Phone: (208) 233-5864
Approximate (ZIP-level) locationGet directions
Mailing address
500 S 11th Ave
Pocatello, ID 83201-4835
Registry dates
- Enumerated
- 2006-08-10
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.