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BOISE PODIATRY CLINIC P. A. NPI 1982711578


NPI Information

NPI: 1982711578
Provider Name: BOISE PODIATRY CLINIC, P. A.

Doing Business As: PODIATRY CENTER OF IDAHO

Classification: Podiatrist - 213EP1101X
Entity Type: Organization

Specialization: Primary Podiatric Medicine

Address:
6051 N EAGLE RD
BOISE, ID
ZIP 83713
Phone: (208) 938-4670
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BOISE PODIATRY CLINIC, P. A. is a primary podiatric medicine podiatrist in Boise, ID. BOISE PODIATRY CLINIC, P. A. NPI is 1982711578. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Podiatry Center Of Idaho.

The provider's business location address is:

6051 N EAGLE RD
BOISE, ID
ZIP 83713
Phone: (208) 938-4670
Fax: (208) 938-4675

The provider's authorized official is Gary J Millward .
The authorized official title is Administrator and has the following contact phone number (208) 938-4670.

The enumeration date for this NPI number is 8/23/2006 and was last updated on 12/11/2007.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1213EP1101XPodiatristPrimary Podiatric MedicineYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11350843MEDICARE ID-TYPE UNSPECIFIEDIDAHOMEDICARE GROUP NUMBER
20779300001MEDICARE NSCIDAHO

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

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