Individual
DR. LISA DRISCOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 706-5100
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M-15996
ID
207R00000X
Internal Medicine Physician
MRM-1713
ID
Other
Enumeration date
04/20/2018
Last updated
11/23/2021
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