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DONRAPHAEL WYNN M.D. NPI 1396188751


NPI Information

NPI: 1396188751
Provider Name: DONRAPHAEL WYNN, M.D.
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Individual

Specialization: Neurology

Organization: SAINT ALPHONSUS REGIONAL MEDICAL CENTER INC

PECOS Registration: Yes

Address:
1072 N LIBERTY ST
STE 303
BOISE, ID
ZIP 83704
Phone: (208) 302-4200
Get Directions

Donraphael Wynn, M.D. is a neurology psychiatry neurology in Boise, ID with 11 years of experience. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. Donraphael Wynn, M.D. NPI is 1396188751. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF IOWA, RJ & L CARVER COLLEGE OF MEDICINE
Graduation Year:2013

The provider's business location address is:

1072 N LIBERTY ST
STE 303
BOISE, ID
ZIP 83704
Phone: (208) 302-4200
Fax: (208) 302-4255

The NPI 1396188751 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/16/2013 and was last updated on 10/24/2018.


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
1207W00000XOphthalmology9164199-1205UTAHNo
22084N0400XPsychiatry & NeurologyNeurologyM-14403IDAHOYes
3207WX0109XOphthalmologyNeuro-ophthalmology9164199-1205UTAHNo

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: 11/14/2023

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.