Idaho Joint And Spine Pc

LBN: Idaho Joint And Spine Pc
Idaho Joint And Spine Pc is an health care organization with primary practice located at 9510 W Fairview Ave , Boise ID 83704-8103. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neuromusculoskeletal Medicine & OMM, Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation. Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation is the primary health care specialty. Idaho Joint And Spine Pc can be contacted via phone (208) 322-5922, or through Whitaker, James A via phone (208) 322-5922.

Contact Information

Primary practice address
9510 W Fairview Ave Boise ID 83704-8103
Phone: (208) 322-5922
Fax: (844) 502-7766
Website:
Map and Directions
Authorized official contact:
Name: Whitaker, James A Doctor of Osteopathy (DO)
Phone: (208) 322-5922

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neuromusculoskeletal Medicine & OMM 204D00000X O-0794 Idaho
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X O-0794 Idaho

Profile Details

NPI number 1356759781
LBN Legal business name Idaho Joint And Spine Pc
DBA Doing business as
Authorized official Whitaker, James A Doctor of Osteopathy (DO)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 29th, 2014
Last updated Apr 12th, 2016 - about 9 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 1356759781 NPPES
Idaho MEDICAID 1356759781-001

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