Individual
DR. KATHLEEN MCGOWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 E IDAHO ST, SUITE 400, BOISE, ID 83712-6223
(208) 345-5250
(208) 345-2364
Mailing address
100 E IDAHO ST, SUITE 400, BOISE, ID 83712-6223
(208) 345-5250
(208) 345-2364
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
M4790
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003838300
—
ID
Enumeration date
09/26/2006
Last updated
04/25/2008
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