Exodus Pain Clinic

LBN: Exodus Pain Clinic
Exodus Pain Clinic is an health care organization with primary practice located at 987 S Allante Pl , Boise ID 83709-1612. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Interventional Pain Medicine, which is considered as the primary health care specialty. Exodus Pain Clinic can be contacted via phone (208) 947-7246, or through Marsh, Daniel via phone (208) 994-2907.

Contact Information

Primary practice address
987 S Allante Pl Boise ID 83709-1612
Phone: (208) 947-7246
Fax: (208) 297-7772
Website:
Map and Directions
Authorized official contact:
Name: Marsh, Daniel Doctor of Medicine (MD)
Phone: (208) 994-2907

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X M9452 Idaho

Profile Details

NPI number 1366849572
LBN Legal business name Exodus Pain Clinic
DBA Doing business as
Authorized official Marsh, Daniel Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 3rd, 2014
Last updated Jun 22nd, 2023 - about 2 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 1366849572 NPPES
Idaho MEDICAID 1356377535

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