WALTER S MEDLIN MD PC (NPI# 1437612447) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437612447 |
| Entity Type | Organization |
| Organization Name | WALTER S MEDLIN MD PC |
| Practice Address |
777 Hospital Way Pocatello ID 83201-5175 |
| Mailing Address |
1046 E 100 S Salt Lake City UT 84102-1520 |
| Practice Telephone | 2082392620 |
| Enumeration Date | 2019-04-08 |
| Last Update Date | 2019-04-08 |
| Authorized Official Name | WALTER SCOTT EDWARDS MEDLIN (OWNER) |
| Authorized Official Telephone | 4062382500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699327684 | Walter S Medlin Md PC | Surgery | 1046 E 100 S Ste A, Salt Lake City, UT 84102-1520 | 2019-07-10 |
| Street Address |
777 HOSPITAL WAY |
| City | POCATELLO |
| State | ID |
| Zip Code | 83201-5175 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104825892 | Gregory S Harrison | Neurological Surgery | 777 Hospital Way, Suite 115, Pocatello, ID 83201-5175 | 2005-07-15 |
| 1801401344 | Sunny Blue Alene Nelson | Physician Assistant | 777 Hospital Way, Pocatello, ID 83201-5175 | 2020-09-11 |
| 1316570757 | Mark Alan Pendleton | Nurse Anesthetist, Certified Registered | 777 Hospital Way, Pocatello, ID 83201-5175 | 2020-02-13 |
| 1508413220 | Hilary Worthen | Specialist/Technologist | 777 Hospital Way, Pocatello, ID 83201-5175 | 2019-08-19 |
| 1396203428 | Amber Frost | Family Medicine | 777 Hospital Way, Pocatello, ID 83201-5175 | 2019-03-07 |
| 1649756404 | Kamilla Gundersen | Nurse Practitioner | 777 Hospital Way, Pocatello, ID 83207 | 2018-07-16 |
| 1043716285 | Brice Anderson | Specialist/Technologist | 777 Hospital Way, Pocatello, ID 83201-5175 | 2018-04-05 |
| 1851808133 | Rocky Mountain Physician Group LLC | Emergency Medicine | 777 Hospital Way, Pocatello, ID 83201-5175 | 2018-01-08 |
| 1154838886 | Mark Willis | Nurse Practitioner | 777 Hospital Way, Pocatello, ID 83201-5175 | 2018-01-03 |
| 1588187892 | Rachel Goulart | Physician Assistant | 777 Hospital Way, Pocatello, ID 83201-5175 | 2017-07-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235765330 | Timothy Palmer | Social Worker | 400 S 11th Ave, Ste 204, Pocatello, ID 83201 | 2020-03-20 |
| 1225687759 | Hanna Percy | Nurse Practitioner | 1151 Hospital Way Ste 201, Pocatello, ID 83201 | 2019-09-07 |
| 1659935195 | Carol Jane Dillon | Counselor | 707 North 7th Avenue, Suite D, Pocatello, ID 83201 | 2019-04-30 |
| 1154801595 | Mv Pocatello Ent, LLC | Otolaryngology | 333 N 18th Ave Ste B3, Pocatello, ID 83201 | 2018-08-15 |
| 1306344346 | Ruth Anne Patton | Social Worker | 850 E Young St, Pocatello, ID 83201 | 2018-01-24 |
| 1598289274 | Lucas Alexander Bryan | Specialist/Technologist | 1535 E Terry St, Pocatello, ID 83201 | 2017-08-03 |
| 1205365632 | Geno Alan Giovanini | Denturist | 115 S. 15th Ave. Ste. D, Pocatello, ID 83201 | 2017-06-08 |
| 1518415942 | Kelli Fries-geslin | Nurse Practitioner | 500 South 11 Ave Suite 400, Pocatello, ID 83201 | 2016-09-14 |
| 1346797842 | Shailyn Jenkins | Specialist/Technologist | 665 Warren Ave., Pocatello, ID 83201 | 2016-09-01 |
| 1992258149 | Christopher Jared White | Social Worker | 300 N 7th Ave, Pocatello, ID 83201 | 2016-07-24 |
| Find all providers in zip 83201 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740360254 | June E Heilman | Surgery | 777 Hospital Way Ste 201, Pocatello, ID 83201-5162 | 2006-10-17 |
| 1356336440 | Claine Doyle Judy | Surgery | 755 Hospital Way, Ste A-5, Pocatello, ID 83201-2717 | 2005-09-14 |
| 1689669772 | David Vance Vanek | Surgery | 9395 W Pocatello Creek Rd, Pocatello, ID 83201-9049 | 2005-09-14 |
| 1134621436 | Bmh Inc. | Surgery | 353 N 4th Ave, Pocatello, ID 83201-6390 | 2018-03-02 |
| 1013455914 | Mvh Surgical Specialists LLC | Surgery | 2240 E Center St, Pocatello, ID 83201-2600 | 2017-02-10 |
| 1184067613 | Mara Additon | Surgery | 777 Hospital Way Ste 201, Pocatello, ID 83201-5175 | 2013-04-15 |
| 1093003808 | Hannah Elizabeth Caulfield | Surgery | 777 Hospital Way, #201, Pocatello, ID 83201-5175 | 2011-07-13 |
| 1053627216 | Tammy Sue Fouse | Surgery | 2486 Cimmaron Cir, Pocatello, ID 83204-7346 | 2010-08-26 |
| 1063730679 | Terrence Michael Rager | Surgery | Portneuf Medical Center, 777 Hospital Way, South Mob, Suite 201, Pocatello, ID 83201 | 2010-05-06 |
| 1386960821 | June E Heilman Md Pa | Surgery | 333 N 18th Ave, Pocatello, ID 83201-3358 | 2010-04-08 |
| Find all providers in POCATELLO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.