NPI age
19 years
Enumerated 2006-06-14
Across 239 active orthopaedic surgery providers in Idaho.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 71753 | BLUE CROSS |
| 01 (ID) | 000010148683 | BLUE SHIELD |
| 01 (ID) | P00190924 | RR MEDICARE |
| 05 (ID) | 807012400 |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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