NPI age
20 years
Enumerated 2006-02-17
Across 68 active podiatrist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 002725800 | |
| 01 (ID) | P1423 | BLUE CROSS OF ID |
| 01 (ID) | 000010015660 | REGENCE BS OF ID |
| 01 | DA8994 | RAILROAD MEDICARE |
Doing-business-as, former, and alternate names recorded by NPPES.
Single-site organization. Only one practice location on file.
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