Organization
Q17 HEALTH PARTNERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUSSELL H GRIFFITHS MD (PRESIDENT)
(208) 433-1736
Entity
Organization
Contact information
Practice address
100 EAST IDAHO STREET #317, BOISE, ID 83712
(208) 433-1736
(208) 433-1738
Mailing address
100 EAST IDAHO STREET #317, BOISE, ID 83712
(208) 433-1736
(208) 433-1738
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805132700
—
ID
Enumeration date
10/11/2018
Last updated
10/17/2018
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