Provider / Organization | NPI | Date Certified |
---|---|---|
IDAHO RETINA CENTER PLLC | 1306400429 | 2021-08-26 |
The organization Idaho Retina Center Pllc is registered with the National Plan and Provider Enumeration System (NPPES) and has the assigned NPI of 1306400429. Registration indicates Idaho Retina Center Pllc is a provider of access to ophthalmic care services with a specialization in Allopathic & Osteopathic Physicians, Ophthalmology (Allopathic & Osteopathic Physicians, Ophthalmology) (Ophthalmology, ) (Vision/Audiology, ) (Ophthalmology, Allopathic & Osteopathic Physicians)
Address | City / State | Phone / Fax |
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16211 N Brinson St Ste 140 | Nampa, ID 836875521 | 2083225996 |
Code | Practice | License No State |
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207W00000X PRIMARY | Access to Ophthalmic Care Allopathic & Osteopathic Physicians Ophthalmology Allopathic & Osteopathic Physicians Ophthalmology Ophthalmology Vision/Audiology Ophthalmology Allopathic & Osteopathic Physicians | |
193400000X SING | Group Code |