NPI age
19 years
Enumerated 2007-02-19
Across 239 active orthopaedic surgery providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 100000294843 | REGENCE |
| 05 (ID) | 0001364855 | |
| 01 (ID) | 11289122 | PTAN |
| 01 (ID) | B6493 | BCID |
| 01 (ID) | B6493 | BLUE CROSS |
| 01 (ID) | P00247850 | RAILROAD MEDICARE |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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