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

St Lukes Clinic - Wood River LLC

Organization Anesthesiology Physician · NPI 1972891604

St Lukes Clinic - Wood River LLC is an Anesthesiology Physician in Ketchum, Idaho. Licensed in Idaho. Registered with an NPI since 2011.

Licensed in
ID
In the registry since
2011
Specialties on file
7
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

100 Hospital Dr
Ketchum, ID 83340-9999
Phone: (208) 727-8100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 62 (ID)
Anesthesiology Physician Taxonomy 207L00000X · Licence 62 (ID)
Emergency Medicine Physician Taxonomy 207P00000X · Licence 62 (ID)
Family Medicine Physician Taxonomy 207Q00000X · Licence 62 (ID)
Obstetrics & Gynecology Physician Taxonomy 207V00000X · Licence 62 (ID)
Orthopaedic Surgery Physician Taxonomy 207X00000X · Licence 62 (ID)
Urology Physician Taxonomy 208800000X · Licence 62 (ID)

Record details

NPI number1972891604
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationSt Lukes Medical Center Woodriver Ltd
Authorized official Kathryn Fowler — Senior Vp, Cfo · (208) 381-8717
NPI enumeratedJuly 15, 2011
Last updated in NPPESApril 23, 2026
Certification dateApril 23, 2026
Mailing addressPo Box 640, Boise, ID 83701-0640

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