Individual
NICHOLAS TYLER GORDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1055 N CURTIS RD, BOISE, ID 83706-1309
(208) 367-3131
Mailing address
1055 N CURTIS RD, BOISE, ID 83706-1309
(208) 367-3131
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
M-14500
ID
207RH0003X
Hematology & Oncology Physician
MD192892
OR
Other
Enumeration date
04/16/2013
Last updated
06/23/2020
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