Organization
FOOT & ANKLE MEDICAL CENTER OF NAMPA, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILLIP NEIL BURK D.P.M. (PRESIDENT)
(208) 466-3338
Entity
Organization
Contact information
Practice address
203 12TH AVE RD, SUITE A, NAMPA, ID 83686-5012
(208) 466-3338
(208) 466-3554
Mailing address
203 12TH AVE RD, SUITE A, NAMPA, ID 83686-5012
(208) 466-3338
(208) 466-3554
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
P-99
ID
332B00000X
Durable Medical Equipment & Medical Supplies
P-99
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010015689
REGENCE BLUE SHIELD
ID
01
—
000010167550
REGENCE BLUE SHIELD
ID
05
—
001519600
—
ID
05
—
808001900
—
IL
01
—
P2446
BLUE CROSS
ID
01
—
P2447
BLUE CROSS
ID
01
—
P9371
BLUE CROSS
ID
Enumeration date
03/22/2007
Last updated
08/25/2008
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