Mcmahon, Douglas B
Mcmahon, Douglas B is an individual health care provider with primary practice located at 12080 W Mcmillan Rd , Boise ID 83713-2462. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Infectious Disease. Allopathic & Osteopathic Physicians / Infectious Disease is his primary health care specialty. Mcmahon, Douglas B can be contacted via phone (208) 375-4955.Contact Information
Primary practice address
12080 W Mcmillan Rd
Boise ID 83713-2462
Phone: (208) 375-4955
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | DO19768 | Oregon |
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | M-17583 | Idaho |
Profile Details
| NPI number | 1568555001 |
|---|---|
| LBN Legal business name | Mcmahon, Douglas B |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 2nd, 2006 |
| Last updated | Dec 19th, 2023 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568555001 | NPPES |
| Oregon | MEDICAID | 079587 | |
| Oregon | Other | 4002804-02 | |
| Oregon | Other | 0237420-02 | |
| Oregon | Other | H2549-02 | |
| Oregon | Other | 122912 |
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