Individual
DONALD GENE CORSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13960 W WAINWRIGHT DR, BOISE, ID 83713-1969
(208) 810-2308
Mailing address
13960 W WAINWRIGHT DR, BOISE, ID 83713-1969
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
M-11635
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
OH
Other
Enumeration date
08/12/2009
Last updated
08/20/2016
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