Healthcare Provider Details

I. General information

NPI: 1649962671
Provider Name (Legal Business Name): NORTH CANYON MEDICAL CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2023
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

426 PARKVIEW LOOP E
TWIN FALLS ID
83301
US

IV. Provider business mailing address

267 N CANYON DR
GOODING ID
83330-5500
US

V. Phone/Fax

Practice location:
  • Phone: 208-934-4433
  • Fax:
Mailing address:
  • Phone: 208-934-4433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. J'DEE M ADAMS
Title or Position: CEO
Credential: CEO
Phone: 208-934-4433