Healthcare Provider Details

I. General information

NPI: 1194826750
Provider Name (Legal Business Name): CATHERINE L. LINDERMAN MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 06/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2375 E SUNNYSIDE RD SUITE A
IDAHO FALLS ID
83404-8280
US

IV. Provider business mailing address

2375 E SUNNYSIDE RD SUITE A
IDAHO FALLS ID
83404-8280
US

V. Phone/Fax

Practice location:
  • Phone: 208-524-0610
  • Fax: 208-557-0171
Mailing address:
  • Phone: 208-524-0610
  • Fax: 208-557-0171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number StateID

VIII. Authorized Official

Name: CATHERINE L LINDERMAN
Title or Position: OWNER
Credential: MD
Phone: 208-524-0610