Organization
IDAHO FOOT & ANKLE ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY R EMMEN (BILLING MANAGER)
(208) 327-0627
Entity
Organization
Contact information
Practice address
809 N LIBERTY ST, BOISE, ID 83704-8703
(208) 327-0627
(208) 376-5258
Mailing address
809 N LIBERTY ST, BOISE, ID 83704-8703
(208) 327-0627
(208) 376-5258
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001970800
—
ID
05
—
002680000
—
ID
05
—
002680100
—
ID
05
—
004395700
—
ID
05
—
805793600
—
ID
Enumeration date
04/09/2007
Last updated
10/13/2011
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