Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | M-12493 | ID |
Y | 207XS0106X | Orthopaedic Hand Surgeon | M12493 | ID |
NPI | 1043474810 |
---|---|
Provider Name | Jeremy P Toomey |
First Address | Boise, ID 83712-6241 |
Second Address | Boise, ID 83702-4565 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2008 |
Last Update Date | 17/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1043474810 | (05) | ID |