NPI age
19 years
Enumerated 2006-08-11
Across 260 active surgery providers in Idaho.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 000010001037 | REGENCE BS BOI |
| 01 (ID) | 000010144925 | REGENBE BS MTN HOME |
| 01 (ID) | 020030135 | TRICARE |
| 05 (ID) | 002279400 | |
| 01 (ID) | B3861 | BLUE CROSS OF ID EMMETT |
| 01 (ID) | 000010149831 | REGENCE BS EMMETT |
| 01 (ID) | B3879 | BC OF IDAHO MTN HOME |
| 01 (ID) | 70334 | BLUE CROSS OF IDAHO BOIS |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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