Idaho State Sports Medicine

LBN: Idaho State University
Idaho State Sports Medicine is an health care organization with primary practice located at 921 S 8Th Ave Stop 8173 Sports And Orthopaedic Center, Pocatello ID 83209-8173. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sports Medicine, Allopathic & Osteopathic Physicians / Orthopaedic Surgery. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty. Idaho State University can be contacted via phone (208) 282-3408, or through Wotowey, Jodi via phone (208) 282-3408.

Contact Information

Primary practice address
921 S 8Th Ave Stop 8173 Sports And Orthopaedic Center Pocatello ID 83209-8173
Phone: (208) 282-3408
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Wotowey, Jodi
Phone: (208) 282-3408

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X

Profile Details

NPI number 1801292115
LBN Legal business name Idaho State University
DBA Doing business as Idaho State Sports Medicine
Authorized official Wotowey, Jodi
Entity Organization
Organization subpart 1 No
Enumeration date Nov 13th, 2014
Last updated Nov 13th, 2014 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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