Vandenburgh, Cortney A
Vandenburgh, Cortney A is an individual health care provider with primary practice located at 1450 Aviation Dr Suite 100, Hailey ID 83333-8785. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Vandenburgh, Cortney A can be contacted via phone (208) 788-3434.Contact Information
Primary practice address
1450 Aviation Dr Suite 100
Hailey ID 83333-8785
Phone: (208) 788-3434
Fax: (208) 788-2025
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | O0419 | Idaho |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MR0827 | Idaho |
Profile Details
| NPI number | 1003852849 |
|---|---|
| LBN Legal business name | Vandenburgh, Cortney A |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 21st, 2006 |
| Last updated | Feb 21st, 2014 - about 11 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 | 1003852849 | NPPES |
| Idaho | MEDICAID | 807191900 | |
| Idaho | Other | P00721168 |
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