Organization
BOISE PATHOLOGY GROUP P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD STILLINGER M.D. (SECRETARY-TREASURER)
(208) 381-2367
Entity
Organization
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2367
Mailing address
PO BOX 9589, BOISE, ID 83707-4589
(208) 472-8104
(208) 344-1926
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
—
—
207ZD0900X
Dermatopathology (Pathology) Physician
Primary
—
—
207ZH0000X
Hematology (Pathology) Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
—
Other
Enumeration date
05/20/2006
Last updated
09/11/2025
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