Organization
EAGLE'S VIEW FAMILY MEDICINE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM BRUS M.D. (SECRETARY)
(208) 938-5524
Entity
Organization
Contact information
Practice address
6023 N EAGLE RD, BOISE, ID 83713-0997
(208) 938-5524
(208) 938-2150
Mailing address
6023 N EAGLE RD, BOISE, ID 83713-0997
(208) 938-5524
(208) 938-2510
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8C-055
BLUE CROSS OF IDAHO
ID
Enumeration date
09/20/2006
Last updated
08/22/2020
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