Retina Specialists Of Idaho, Pllc

LBN: Retina Specialists Of Idaho, Pllc
Retina Specialists Of Idaho, Pllc is an health care organization with primary practice located at 13923 W Wainwright Dr Suite 301, Boise ID 83713-1969. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as the primary health care specialty. Retina Specialists Of Idaho, Pllc can be contacted via phone (208) 938-5624, or through Roberts, Denton R. via phone (208) 938-5624.

Contact Information

Primary practice address
13923 W Wainwright Dr Suite 301 Boise ID 83713-1969
Phone: (208) 938-5624
Fax: (208) 938-5764
Website:
Map and Directions
Authorized official contact:
Name: Roberts, Denton R. Doctor of Medicine (MD)
Phone: (208) 938-5624

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X M-10066 Idaho

Profile Details

NPI number 1366607996
LBN Legal business name Retina Specialists Of Idaho, Pllc
DBA Doing business as
Authorized official Roberts, Denton R. Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 23rd, 2008
Last updated Apr 10th, 2012 - about 13 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 1366607996 NPPES
Idaho MEDICAID 808025900

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