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

Southeastern Idaho Surgical Associates, PLLC

Organization Surgery Physician · NPI 1164372777

Southeastern Idaho Surgical Associates, PLLC provides Surgery Physician services 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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