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General NPI Number Information
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NPI Number | 1326206947
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Entity Type | Organization
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Legal Business Name | WALTER KNOX MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 05/30/2008
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Last Update Date | 11/30/2019
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Provider Practice Location Address
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Address Line | 1024 E LOCUST ST
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City | EMMETT
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State | ID
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Zip | 83617-2776
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Country | US
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Telephone | 208-365-3561
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Fax | 208-365-4176
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Provider Business Mailing Address
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Address Line | 1202 E LOCUST ST
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City | EMMETT
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State | ID
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Zip | 83617-2715
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Country | US
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Telephone | 208-365-3561
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Fax | 208-365-4176
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Authorized Official
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Title or Position | CFO
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Name | PAM STAMPFLI
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Credential |
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Telephone | 208-901-3213
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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