Provider Type Icon

LAWRENCE D ANDERSON MD ESTATE NPI 1326550096


NPI Information

NPI: 1326550096
Provider Name: LAWRENCE D ANDERSON MD ESTATE

Doing Business As: MAPLE GROVE EYE CLINIC

Classification: Ophthalmology - 207W00000X
Entity Type: Organization

CLIA Number: 13D2000453

Address:
8955 W HACKAMORE DR
BOISE, ID
ZIP 83709
Phone: (208) 344-7944
Get Directions

LAWRENCE D ANDERSON MD ESTATE is an ophthalmology in Boise, ID. The provider is an ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. LAWRENCE D ANDERSON MD ESTATE NPI is 1326550096. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Maple Grove Eye Clinic.

The provider's business location address is:

8955 W HACKAMORE DR
BOISE, ID
ZIP 83709
Phone: (208) 344-7944
Fax: (208) 343-4676

The provider's authorized official is Nathan B Anderson .
The authorized official title is Personal Representative and has the following contact phone number (208) 344-7944.

The CLIA number assigned to this NPI record is 13D2000453 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/2/2017 and was last updated on 4/10/2019.


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
1152W00000XOptometristNo
2207W00000XOphthalmologyYes

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
11326302548MEDICAIDIDAHO
21942316054MEDICAIDIDAHO

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.