Sun Valley Sports Medicine, P.A.

LBN: Sun Valley Sports Medicine, P.A.
Sun Valley Sports Medicine, P.A. is an health care organization with primary practice located at 191 5Th St W , Ketchum ID 83340. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is the primary health care specialty. Sun Valley Sports Medicine, P.A. can be contacted via phone (208) 726-5207, or through Wasilweski, Stephen via phone (208) 726-5207.

Contact Information

Primary practice address
191 5Th St W Ketchum ID 83340
Phone: (208) 726-5207
Fax: (208) 726-8948
Website:
Map and Directions
Authorized official contact:
Name: Wasilweski, Stephen Doctor of Medicine (MD)
Phone: (208) 726-5207

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X

Profile Details

NPI number 1124061163
LBN Legal business name Sun Valley Sports Medicine, P.A.
DBA Doing business as
Authorized official Wasilweski, Stephen Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 14th, 2006
Last updated Jun 17th, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124061163 NPPES
Idaho Other 200015728 RR MEDICARE
Idaho MEDICAID 805960600 RR MEDICARE

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