Individual
DR. STEPHEN THOMAS REINSCHMIDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
5680 W GAGE ST, BOISE, ID 83706-1326
(208) 377-3937
(208) 377-9455
Mailing address
5680 W GAGE ST, BOISE, ID 83706-1326
(208) 377-3937
(208) 377-9455
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
323
AK
152W00000X
Optometrist
Primary
ODP-100417
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1205161387
—
ID
01
—
APPLIED FOR
MEDICAID, MEDICARE PIN (APPLIED FOR)
AK
Enumeration date
10/07/2009
Last updated
05/08/2023
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