Cusack, Barry Justin
Cusack, Barry Justin is an individual health care provider with primary practice located at 500 West Fort St (111), Boise ID 83702-4598. He recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Medicine, which is considered as his primary health care specialty. Cusack, Barry Justin can be contacted via phone (208) 422-1000.Contact Information
Primary practice address
500 West Fort St (111)
Boise ID 83702-4598
Phone: (208) 422-1000
Fax: (208) 422-1319
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Geriatric Medicine | 207RG0300X | M5678 | Idaho |
Profile Details
NPI number | 1720187289 |
---|---|
LBN Legal business name | Cusack, Barry Justin |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Sep 21st, 2006 |
Last updated | Jul 8th, 2007 - about 17 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 | 1720187289 | NPPES |
Idaho | Other | M5678 | STATE MEDICAL LICENCE |
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