Sonntag, John R

Sonntag, John R is an individual health care provider with primary practice located at 5680 W Gage St , Boise ID 83706-1326. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Sonntag, John R can be contacted via phone (208) 377-3937.

Contact Information

Primary practice address
5680 W Gage St Boise ID 83706-1326
Fax: (208) 377-9455
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X M4623 Idaho

Profile Details

NPI number 1245223809
LBN Legal business name Sonntag, John R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 29th, 2005
Last updated Jun 25th, 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 1245223809 NPPES
Idaho MEDICAID 001553800

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