Individual
VAUN J ARCHIBALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1072 N LIBERTY ST, SUITE 203, BOISE, ID 83704-8708
(208) 367-4321
(208) 367-4525
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 367-5170
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
O-0449
ID
2080A0000X
Pediatric Adolescent Medicine Physician
O-0449
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807789500
—
ID
Enumeration date
01/17/2006
Last updated
06/04/2013
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