Digestive Health Clinic Llc

LBN: Digestive Health Clinic Llc
Digestive Health Clinic Llc is an health care organization with primary practice located at 6259 W Emerald St , Boise ID 83704-8731. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as the primary health care specialty. Digestive Health Clinic Llc can be contacted via phone (208) 489-1900, or through Mallory, Mark A via phone (208) 489-1900.

Contact Information

Primary practice address
6259 W Emerald St Boise ID 83704-8731
Phone: (208) 489-1900
Fax: (208) 375-5286
Website:
Map and Directions
Authorized official contact:
Name: Mallory, Mark A Doctor of Medicine (MD)
Phone: (208) 489-1900

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X

Profile Details

NPI number 1750498333
LBN Legal business name Digestive Health Clinic Llc
DBA Doing business as
Authorized official Mallory, Mark A Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 23rd, 2006
Last updated Jul 24th, 2020 - about 5 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 1750498333 NPPES
Idaho MEDICAID 807631700

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