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

Southeast Idaho Gastroenterology, PLLC

Organization Medical Physician Assistant · NPI 1780867457

Southeast Idaho Gastroenterology, PLLC is a Medical Physician Assistant in Pocatello, Idaho. Licensed in Idaho. Registered with an NPI since 2007.

Licensed in
ID
In the registry since
2007
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1151 Hospital Way Ste A
Pocatello, ID 83201-5091
Phone: (208) 232-6616
Fax: (208) 232-6618
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA-629 (ID)

Record details

NPI number1780867457
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Debbie Ferrel — Practice Manager · (208) 232-6616
NPI enumeratedDecember 17, 2007
Last updated in NPPESDecember 17, 2007
Mailing address1151 Hospital Way Ste A, Pocatello, ID 83201-5091

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