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Individual

MR. JAMES D. MCCOLLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.P.A.S., PA-C

Contact information

Practice address
444 W FORT ST., CRH 2ND FLOOR, BOISE, ID 83702-4535
(208) 422-1018
Mailing address
444 W FORT ST., CRH 2ND FLOOR, BOISE, ID 83702-4535
(208) 422-1018

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA570
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
807282900
ID
Enumeration date
07/12/2006
Last updated
09/28/2023
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