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

Southeastern Idaho Surgical Associates, PLLC

Organization Surgery Physician · NPI 1164372777

Southeastern Idaho Surgical Associates, PLLC is a Surgery Physician in Idaho Falls, Idaho. Registered with an NPI since 2026.

In the registry since
2026
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

2805 Valencia Dr
Idaho Falls, ID 83404-7597
Phone: (208) 525-9400
Fax: (208) 525-6151
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X

Record details

NPI number1164372777
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Brett McBride — Owner · (208) 525-9400
NPI enumeratedFebruary 2, 2026
Last updated in NPPESApril 3, 2026
Certification dateApril 3, 2026
Mailing address2805 Valencia Dr, Idaho Falls, ID 83404-7597

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