Organization
CARDIAC CIN OF BOISE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD LELAND HUTTON EADIE (DIRECTOR)
(615) 733-2064
Entity
Organization
Contact information
Practice address
800 W MAIN ST STE 1460-10, BOISE, ID 83702-5945
(615) 386-0064
(615) 386-0067
Mailing address
102 WOODMONT BLVD STE 350, NASHVILLE, TN 37205-2216
(615) 386-0064
(615) 386-0067
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
ID
207RI0011X
Interventional Cardiology Physician
—
ID
Other
Enumeration date
02/05/2018
Last updated
02/05/2018
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