OrganizationActive
St Luke'S Regional Medical Center
NPI 1801197082 · Pediatric Gastroenterology Physician · Boise, ID
Provider details
- NPI number
- 1801197082
- Entity type
- Organization
- Primary specialty
- Pediatric Gastroenterology PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- St Luke'S Regional Medical Center
- Organization subpart
- Yes
- Authorized official
- Jeff Taylor, System Vp Cfo(208) 381-2520
- License
- 03 (ID)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
100 E Idaho St
Ste 316
Boise, ID 83712-6267
Phone: (208) 381-7310
Approximate (ZIP-level) locationGet directions
Mailing address
100 E Idaho St
Boise, ID 83712-6267
Other names (DBA / former)
- Doing business as
- St Luke'S Clinic - Idaho Pediatric Gastroenterology
Registry dates
- Enumerated
- 2010-11-04
- Last updated
- 2010-11-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.