Healthcare Provider Details

I. General information

NPI: 1326206947
Provider Name (Legal Business Name): WALTER KNOX MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2008
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1024 E LOCUST ST
EMMETT ID
83617-2776
US

IV. Provider business mailing address

1202 E LOCUST ST
EMMETT ID
83617-2715
US

V. Phone/Fax

Practice location:
  • Phone: 208-365-2338
  • Fax: 208-365-0677
Mailing address:
  • Phone: 208-365-3561
  • Fax: 208-365-4176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: BRAD TURPEN
Title or Position: CEO
Credential:
Phone: 208-365-3561