Individual
JEFFREY G FLAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
6140 W CURTISIAN AVE, SUITE 400, BOISE, ID 83704-8907
(208) 327-5600
(208) 327-5602
Mailing address
6140 W CURTISIAN AVE, STE 400, BOISE, ID 83704-8907
(208) 327-5600
(208) 327-5602
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA317
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100001052280
REGENCE BLUESHIELD OF IDAHO
ID
05
—
1295780062
—
ID
01
—
PA132
BLUE CROSS OF IDAHO
ID
Enumeration date
05/23/2006
Last updated
05/09/2022
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