# BOISE VALLEY DOCTORS, P.A.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Firstline Medical
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578741393
- **Authorized official:** ALLEN ROGER NEUENSCHWANDER M.D. (CEO)
- **Authorized official phone:** (208) 323-7588

## Contact information

- **Practice address:** 6000 W OVERLAND RD, BOISE, ID 83709-3013
- **Practice address phone:** (208) 323-7588
- **Practice address fax:** (208) 515-3468
- **Mailing address:** PO BOX 7667, BOISE, ID 83707-1667
- **Mailing address phone:** (208) 323-7588
- **Mailing address fax:** (208) 515-3468

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | M-2852 | ID | Yes |

## Other

- **Enumeration date:** 02/04/2008
- **Last updated:** 12/15/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | M-2852 | MEDICAL LICENSE | ID |