Individual
DR. NIKOLAI SOPKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
775 POLE LINE RD W STE 301, TWIN FALLS, ID 83301-5823
(208) 814-8700
(208) 933-4914
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
AJ414735
MD
208800000X
Urology Physician
M-15541
ID
Other
Enumeration date
03/29/2012
Last updated
10/05/2023
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