Organization
IDAHO JOINT AND SPINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES A WHITAKER DO (OWNER)
(208) 322-5922
Entity
Organization
Contact information
Practice address
1760 N MITCHELL ST, BOISE, ID 83704-6542
(208) 322-5922
(208) 576-6932
Mailing address
1760 N MITCHELL ST, BOISE, ID 83704-6542
(208) 322-5922
(208) 576-6932
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
O-0794
ID
208100000X
Physical Medicine & Rehabilitation Physician
Primary
O-0794
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1356759781-001
—
ID
Enumeration date
07/29/2014
Last updated
09/10/2025
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