Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | M-11974 | ID |
Y | 207XS0106X | Orthopaedic Hand Surgeon | M-11974 | ID |
NPI | 1205032901 |
---|---|
Provider Name | Dr. Jeffrey Scott Boyer |
First Address | Boise, ID 83706-1338 |
Second Address | Boise, ID 83706-1338 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2007 |
Last Update Date | 08/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
20003325 | (02) | ID |