Blue, Sky R
Blue, Sky R is an individual health care provider with primary practice located at 125 E Idaho St Suite 203, Boise ID 83712-6212. He recently has only one registered license in Allopathic & Osteopathic Physicians / Infectious Disease, which is considered as his primary health care specialty. Blue, Sky R can be contacted via phone (208) 338-0148.Contact Information
Primary practice address
125 E Idaho St Suite 203
Boise ID 83712-6212
Phone: (208) 338-0148
Fax: (208) 336-4027
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | M7398 | Idaho |
Profile Details
| NPI number | 1659365575 |
|---|---|
| LBN Legal business name | Blue, Sky R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 7th, 2005 |
| Last updated | Jul 8th, 2007 - about 18 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 | 1659365575 | NPPES |
| Idaho | Other | 000010000484 | REGENCE BLUE SHIELD OF ID |
| Idaho | Other | J1676 | REGENCE BLUE SHIELD OF ID |
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