NPI age
19 years
Enumerated 2006-06-15
Across 598 active optometrist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 806418901 | |
| 05 (ID) | 806418900 | |
| 01 (ID) | V6945 | BLUE CROSS GROUP # |
| 01 (ID) | 000010139527 | BLUE SHIELD OF IDAHO |
| 01 (ID) | V6952 | BLUE CROSS IDAHO |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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