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

Pocatello Hospital LLC

Organization Internal Medicine Physician · NPI 1760610935

Pocatello Hospital LLC is an Internal Medicine Physician in Pocatello, Idaho. Licensed in Idaho. Registered with an NPI since 2009.

Licensed in
ID
In the registry since
2009
Specialties on file
3
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

651 Memorial Dr
Pocatello, ID 83201-4071
Phone: (208) 239-2110
Fax: (208) 239-2145
Show map & directions

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

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X
General Acute Care Hospital Taxonomy 282N00000X · Licence 12 (ID)
Certified Registered Nurse Anesthetist Taxonomy 367500000X

Record details

NPI number1760610935
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Stephen Petrovich — Evp, General Counsel · (615) 296-3594
NPI enumeratedJune 26, 2009
Last updated in NPPESApril 19, 2022
Certification dateApril 19, 2022
Mailing address651 Memorial Dr, Pocatello, ID 83201-4071

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