Madsen, Kenneth
Madsen, Kenneth is an individual health care provider with primary practice located at 1075 N Curtis Rd Ste 101 , Boise ID 83706-1348. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Vascular Surgery is his primary health care specialty. Madsen, Kenneth can be contacted via phone (208) 302-2800.Contact Information
Primary practice address
1075 N Curtis Rd Ste 101
Boise ID 83706-1348
Phone: (208) 302-2800
Fax: (208) 302-2825
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 6720A | Wyoming |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 2018-01195 | North Carolina |
| Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | 6720A | Wyoming |
| Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | M-12372 | Idaho |
| Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | ME153722 | Florida |
Profile Details
| NPI number | 1164412862 |
|---|---|
| LBN Legal business name | Madsen, Kenneth |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 24th, 2005 |
| Last updated | Oct 24th, 2023 - about last year |
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 | 1164412862 | NPPES |
| Colorado | MEDICAID | 01371657 | |
| Colorado | MEDICAID | 121692900 |
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