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MOUNTAIN MEDICAL PHYSICIAN SPECIALISTS OF IDAHO PC
NPI 1053597237
Radiology - Diagnostic Radiology in Burley, ID

Active since January 17, 2008
1501 HILAND AVE, BURLEY, ID 83318(801) 284-1755(801) 262-3897 Get Directions Write a Review

NPPES record last updated: November 12, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mountain Medical Physician Specialists Of Idaho Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOUNTAIN MEDICAL PHYSICIAN SPECIALISTS OF IDAHO PC (NPI 1053597237) is a healthcare organization registered as a diagnostic radiology in Burley, Idaho and active in the NPI registry since January 2008. The organization lists Clark A Davis, Ceo, as its authorized official.

NPPES Registry Identity

NPI1053597237
Entity TypeOrganization
Primary Taxonomy2085R0202X
Legal Business NameMOUNTAIN MEDICAL PHYSICIAN SPECIALISTS OF IDAHO PC
Location Address1501 HILAND AVEBurley, ID 83318-2682
Mailing Address5444 Green StMurray, UT 84123-5632 · (801) 284-1755 · Fax (801) 262-3897
Phone(801) 284-1755
Fax(801) 262-3897
Organization SubpartNo
Authorized OfficialClark A DavisCeo · (801) 284-1705
Enumeration DateJanuary 17, 2008
Last NPPES UpdateNovember 12, 2008
✔ NPI 1053597237 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
License✔ Licensed in ID · C176456
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
1501 HILAND AVE, Burley, ID 83318
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TENNILLE IRENE HOUSTON MHE, RD, LD, CDE
Dietitian, Registered
1501 HILAND AVE, CASSIA REGIONAL MEDICAL CENTER
BURLEY, ID 83318
Cassia County (208) 677-6587
JENNIFER RAAE-NIELSEN MD
Emergency Medicine
1501 HILAND AVE
BURLEY, ID 83318
Cassia County (516) 593-1380
HEATHER TANNER ANTHON
Speech-Language Pathologist
1501 HILAND AVE
BURLEY, ID 83318
Cassia County (208) 677-6530
IHC HEALTH SERVICES INC
Obstetrics & Gynecology
1501 HILAND AVE
BURLEY, ID 83318
Cassia County (208) 677-6215
SNARR ANESTHESIA SERVICES PLLC
Nurse Anesthetist, Certified Registered
1501 HILAND AVE
BURLEY, ID 83318
Cassia County (208) 677-8888
DR. TYLER CARLEN DPT
Physical Therapist
1501 HILAND AVE
BURLEY, ID 83318
Cassia County (208) 677-6530
MRS. LADEAN I PACE PTA
Physical Therapy Assistant
1501 HILAND AVE
BURLEY, ID 83318
Cassia County (208) 678-4444
DR. SHILOH GILBERT M.D.
Emergency Medicine
1501 HILAND AVE
BURLEY, ID 83318
Cassia County (866) 415-6556

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mountain Medical Physician Specialists Of Idaho PC's NPI number?

The NPI number for Mountain Medical Physician Specialists Of Idaho PC is 1053597237. It was assigned to this organization in the NPPES registry on January 17, 2008.

Where is Mountain Medical Physician Specialists Of Idaho PC located?

Mountain Medical Physician Specialists Of Idaho PC is located at 1501 Hiland Ave, Burley, ID 83318. The listed phone number is (801) 284-1755.

What is Mountain Medical Physician Specialists Of Idaho PC's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

When was this NPI record last updated?

The NPPES record for Mountain Medical Physician Specialists Of Idaho PC was last updated on November 12, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.