Boerner, Mark J
Boerner, Mark J is an sole proprietor health care provider with primary practice located at 111 W Main St Ste 200 , Boise ID 83702-7308. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Boerner, Mark J can be contacted via phone (208) 344-3220.Contact Information
Primary practice address
111 W Main St Ste 200
Boise ID 83702-7308
Phone: (208) 344-3220
Fax: (208) 344-0461
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | M7206 | Idaho |
Profile Details
| NPI number | 1003819459 |
|---|---|
| LBN Legal business name | Boerner, Mark J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 31st, 2005 |
| Last updated | Apr 15th, 2020 - about 4 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 | 1003819459 | NPPES |
| Idaho | Other | 180038677 | RAILROAD MEDICARE |
| Idaho | MEDICAID | 804243800 | RAILROAD MEDICARE |
| Idaho | Other | J5164 | RAILROAD MEDICARE |
| Idaho | Other | 000010002554 | RAILROAD MEDICARE |
| Idaho | Other | 1317920001 | RAILROAD MEDICARE |
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