Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | M7418 | ID |
N | 207VG0400X | Gynecologist | M7418 | ID |
N | 207VX0000X | Obstetrician | M7418 | ID |
NPI | 1396796207 |
---|---|
Provider Name | Dr. Timothy A West |
First Address | Boise, ID 83712-6241 |
Second Address | Boise, ID 83712-6267 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2006 |
Last Update Date | 20/09/2012 |