Healthcare Provider Details

I. General information

NPI: 1649191255
Provider Name (Legal Business Name): GEM STATE HOSPITAL MEDICINE PHYSICIANS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 HOSPITAL WAY
POCATELLO ID
83201-5175
US

IV. Provider business mailing address

400 GALLERIA PKWY SE STE 960
ATLANTA GA
30339-5980
US

V. Phone/Fax

Practice location:
  • Phone: 208-239-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: BOYKIN ROBINSON
Title or Position: CEO
Credential:
Phone: 404-500-8147