Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 2324 | CO |
N | 111NI0900X | Internist | 2324 | CO |
N | 207RI0011X | Interventional Cardiology | 53884 | CO |
Y | 207RI0011X | Interventional Cardiology | M-13170 | ID |
NPI | 1023210515 |
---|---|
Provider Name | Dr. David Joseph Coyle |
First Address | Boise, ID 83712-6241 |
Second Address | Boise, ID 83712-6241 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2007 |
Last Update Date | 06/04/2016 |