Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mountain Medical Physician Specialists of Idaho PC

Organization Diagnostic Radiology Physician · NPI 1053597237

Mountain Medical Physician Specialists of Idaho PC is a Diagnostic Radiology Physician in Burley, Idaho. Licensed in Idaho. Registered with an NPI since 2008.

Licensed in
ID
In the registry since
2008
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

1501 Hiland Ave
Burley, ID 83318-2682
Phone: (801) 284-1755
Fax: (801) 262-3897
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence C176456 (ID)

Record details

NPI number1053597237
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Clark Davis — Ceo · (801) 284-1705
NPI enumeratedJanuary 17, 2008
Last updated in NPPESNovember 12, 2008
Mailing address5444 Green St, Murray, UT 84123-5632

Other providers in Burley