Roberts, Layne D.

Roberts, Layne D. is an sole proprietor health care provider with primary practice located at 2000 American Legion Blvd , Mountain Home ID 83647-3138. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Roberts, Layne D. can be contacted via phone (208) 587-1500.

Contact Information

Primary practice address
2000 American Legion Blvd Mountain Home ID 83647-3138
Phone: (208) 587-1500
Fax: (208) 587-3180
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X O-91 Idaho

Profile Details

NPI number 1902809205
LBN Legal business name Roberts, Layne D.
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 31st, 2005
Last updated Sep 27th, 2012 - about 13 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 1902809205 NPPES
Idaho Other 000010002108 BLUE SHIELD OF IDAHO
Idaho Other 080177677 BLUE SHIELD OF IDAHO
Idaho MEDICAID 003897000 BLUE SHIELD OF IDAHO
Idaho Other S3374 BLUE SHIELD OF IDAHO

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