Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Southeast Idaho Gastroenterology, PLLC

Organization Medical Physician Assistant · NPI 1780867457

Southeast Idaho Gastroenterology, PLLC provides Medical Physician Assistant services 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 Not confirmed with CMS for 18 years — call before visiting
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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