| Organization Name: | NORTH IDAHO NEUROSURGERY AND SPINE, PLLC |
| NPI Number: | 1134219330 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JEFFREY DEAN MCDONALD (OWNER) |
| Mailing Address: | 1641 E. Polston Ave. Post Falls |
| State: | ID US |
| Postal Code: | 83854 |
| Phone Number: | 2087777555 |
| Fax Number: | 2087773337 |
| NPI Enumeration Date: | 10/16/2006 |
| NPI Last Update Date: | 04/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204D00000X |
| License Number: | M-7768 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Neuromusculoskeletal Medicine & OMM |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |