Individual
DR. DOUGLAS B MCMAHON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
12080 W MCMILLAN RD, BOISE, ID 83713-2462
(208) 375-4955
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0-1839
ID
207Q00000X
Family Medicine Physician
DO19768
OR
207RI0200X
Infectious Disease Physician
Primary
M-17583
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0237420-02
REGENCE BLUE CROSS OF OR
OR
05
—
079587
—
OR
01
—
122912
DEPT OF LABOR WORK COMP
OR
01
—
4002804-02
REGENCE PC 65
OR
01
—
H2549-02
PACIFIC SOURCE
OR
Enumeration date
10/02/2006
Last updated
01/16/2026
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