Fethke, Kathryn M

Fethke, Kathryn M is an individual health care provider with primary practice located at 999 N. Curtis Suite 205, Boise ID 83706. She recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as her primary health care specialty. Fethke, Kathryn M can be contacted via phone (208) 373-1200.

Contact Information

Primary practice address
999 N. Curtis Suite 205 Boise ID 83706
Fax: (208) 373-1216
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X M7977 Idaho

Profile Details

NPI number 1578657094
LBN Legal business name Fethke, Kathryn M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 2nd, 2006
Last updated Jul 8th, 2007 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578657094 NPPES
Idaho Other 000010029522 REGENCE BLUE SHIELD OF ID
Idaho Other 37879 REGENCE BLUE SHIELD OF ID

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