Individual
DR. CLIFFORD KENT BOESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 EDMUNDSON PL, STE 500, COUNCIL BLUFFS, IA 51503-4619
(712) 323-5333
(712) 323-3252
Mailing address
1 EDMUNDSON PL, STE 500, COUNCIL BLUFFS, IA 51503-4619
(712) 323-5333
(712) 323-3252
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
19711
NE
207X00000X
Orthopaedic Surgery Physician
Primary
30053
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0111260
—
IA
01
—
16464
WELLMARK
IA
01
—
200017652
MEDICARE TRAVELERS
IA
Enumeration date
07/07/2005
Last updated
07/12/2012
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