BOISE LASER AND COSMETIC SURGERY CENTER PC NPI 1649410218

NPI Information

NPI: 1649410218
Provider Name: BOISE LASER AND COSMETIC SURGERY CENTER PC
Classification: Otolaryngology - 207YS0123X
Entity Type: Organization

Specialization: Facial Plastic Surgery

Address:
6077 N EAGLE RD
BOISE, ID
ZIP 83713
Phone: (208) 939-9000
Get Directions

BOISE LASER AND COSMETIC SURGERY CENTER PC is a facial plastic surgery otolaryngology in Boise, ID. The provider is an otolaryngologist who specializes in facial plastic surgery. BOISE LASER AND COSMETIC SURGERY CENTER PC NPI is 1649410218. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

6077 N EAGLE RD
BOISE, ID
ZIP 83713-997
Phone: (208) 939-9000
Fax: (208) 939-9580

The provider's authorized official is Bret J Rodgers .
The authorized official title is Physician and has the following contact phone number (208) 939-9000.

The enumeration date for this NPI number is 2/23/2009 and was last updated on 11/8/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207YS0123X	Otolaryngology	Facial Plastic Surgery			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	1101650	MEDICARE PIN	IDAHO
2	806174700	MEDICAID	IDAHO
3	H26494	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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