Archibald, Vaun J

Archibald, Vaun J is an individual health care provider with primary practice located at 1072 N Liberty St Suite 203, Boise ID 83704-8708. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Adolescent Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Archibald, Vaun J can be contacted via phone (208) 367-4321.

Contact Information

Primary practice address
1072 N Liberty St Suite 203 Boise ID 83704-8708
Phone: (208) 367-4321
Fax: (208) 367-4525
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X O-0449 Idaho
Allopathic & Osteopathic Physicians / Pediatrics 208000000X O-0449 Idaho

Profile Details

NPI number 1417937517
LBN Legal business name Archibald, Vaun J
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 17th, 2006
Last updated Jun 4th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417937517 NPPES
Idaho MEDICAID 807789500

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