NPI age
19 years
Enumerated 2006-12-07
Across 598 active optometrist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | V7269 | BLUE CROSS |
| 05 (ID) | 002609700 | |
| 01 (ID) | 410041059 | MEDICARE RAILROAD |
| 01 (ID) | 000010015228 | BLUE SHIELD |
| 01 (ID) | CS9984 | CONTROLLED SUBSTANCE |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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