# IDAHO PAIN CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386605236
- **Authorized official:** RICHARD ALAN DUBOSE MD (PRESIDENT)
- **Authorized official phone:** (208) 323-6273

## Contact information

- **Practice address:** 8950 W EMERALD, STE 168, BOISE, ID 83704
- **Practice address phone:** (208) 323-6273
- **Practice address fax:** (208) 323-6277
- **Mailing address:** 8950 W EMERALD, STE 168, BOISE, ID 83704
- **Mailing address phone:** (208) 323-6273
- **Mailing address fax:** (208) 323-6277

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208VP0000X | Pain Medicine Physician | — | NULL | Yes |
| 208VP0000X | Pain Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/30/2006
- **Last updated:** 08/22/2020