NPI age
19 years
Enumerated 2006-08-20
Across 122 active ophthalmology providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 002797900 | |
| 01 (ID) | 000010032972 | REGENCE BLUE SHIELD |
| 01 (ID) | J4431 | BLUE CROSS |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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