Organization
BOISE SHOULDER CLINIC, PA
Active
Organization
BOISE SHOULDER CLINIC, PA
Active
Other names
Humphrey Shoulder Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARL SCOTT HUMPHREY MD (OWNER)
(208) 639-4800
Entity
Organization
Contact information
Practice address
3381 W BAVARIA STREET, EAGLE, ID 83616-5341
(208) 639-4800
(208) 639-4801
Mailing address
3381 W BAVARIA STREET, EAGLE, ID 83616-5341
(208) 639-4800
(208) 639-4801
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
M9563
ID
Other
Enumeration date
09/21/2006
Last updated
02/13/2012
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