Individual
JON R FISHBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
999 N CURTIS RD, STE 205, BOISE, ID 83706-1336
(208) 373-1200
Mailing address
999 N CURTIS RD, STE 205, BOISE, ID 83706-1336
(208) 373-1200
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
M7225
ID
Other
Enumeration date
05/19/2006
Last updated
10/20/2010
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