Organization
RONALD E JUTZY MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD E JUTZY MD (OWNER)
(208) 367-3500
Entity
Organization
Contact information
Practice address
6140 CURTISIAN AVE, SUITE 400, BOISE, ID 83704-8880
(208) 367-3500
(208) 367-2968
Mailing address
6140 CURTISIAN AVE, SUITE 400, BOISE, ID 83704-8880
(208) 367-3500
(208) 367-2968
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
M5302
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003530200
—
ID
01
—
12
WA DEPARTMENT OF LABOR
WA
01
—
190686
OMAP
OR
01
—
202662100
U S DEPARTMENT OF LABOR
—
01
—
72439
BLUE CROSS OF IDAHO
ID
05
—
806667900
—
ID
01
—
8K321
BLUE CROSS OF IDAHO GROUP
ID
Enumeration date
08/05/2006
Last updated
07/09/2008
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