Individual
MR. LOUIS A ROSER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1880 JUDITH LANE, BOISE, ID 83705-3185
(208) 302-5200
(208) 302-5225
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 302-5200
(208) 302-5225
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M-7135
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8043004
—
ID
Enumeration date
03/28/2006
Last updated
11/28/2016
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