Organization
THE SHOULDER CLINIC OF IDAHO PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS EARL GOODWIN M.D. (OWNER)
(208) 323-4747
Entity
Organization
Contact information
Practice address
8854 W EMERALD ST, STE 102, BOISE, ID 83704-4844
(208) 323-4747
(208) 323-4848
Mailing address
1940 S BONITO WAY STE 190, MERIDIAN, ID 83642-5618
(208) 287-9420
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
11/28/2006
Last updated
03/14/2023
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