Boise Family Medicine Center

LBN: Boise Family Medicine Center
Boise Family Medicine Center is an health care organization with primary practice located at 10798 W. Overland Rd , Boise ID 83709-1329. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Boise Family Medicine Center can be contacted via phone (208) 377-3368, or through Mock, Dale L via phone (208) 377-3368.

Contact Information

Primary practice address
10798 W. Overland Rd Boise ID 83709-1329
Phone: (208) 377-3368
Fax: (208) 322-4691
Website:
Map and Directions
Authorized official contact:
Name: Mock, Dale L Doctor of Medicine (MD)
Phone: (208) 377-3368

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1376747790
LBN Legal business name Boise Family Medicine Center
DBA Doing business as
Authorized official Mock, Dale L Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 11th, 2007
Last updated Sep 8th, 2010 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376747790 NPPES
Idaho MEDICAID 002643200
Idaho Other 32110
Idaho Other 000010006306
Idaho Other 000010006306
Idaho Other 32110

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