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:
Health care specialties
| Specialty | Code | License # | 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 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417937517 | NPPES |
| Idaho | MEDICAID | 807789500 |
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