Individual
DR. SCOTT ALLEN SHAPPARD SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
10255 W. OVERLAND RD, BOISE, ID 83709-1430
(208) 302-5600
(208) 302-5655
Mailing address
3340 EAST GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 302-5600
(208) 302-5655
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
O-292
ID
207Q00000X
Family Medicine Physician
O292
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806344300
—
ID
Enumeration date
06/16/2005
Last updated
11/15/2016
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