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

Pocatello Pulmonary PC

Organization Pulmonary Disease Physician · NPI 1497766240

Pocatello Pulmonary PC is a Pulmonary Disease Physician in Pocatello, Idaho. Licensed in Idaho. Registered with an NPI since 2006.

Licensed in
ID
In the registry since
2006
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

500 S 11th Ave Ste 305
Pocatello, ID 83201-4835
Phone: (208) 233-5864
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pulmonary Disease Physician (primary) Taxonomy 207RP1001X · Licence M5647 (ID)

Record details

NPI number1497766240
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Cary Jackson — President · (208) 233-5864
NPI enumeratedAugust 10, 2006
Last updated in NPPESAugust 22, 2020
Mailing address500 S 11th Ave, Suite 305, Pocatello, ID 83201-4835

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