Individual
TAYLOR JACOB BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1055 N CURTIS RD, BOISE, ID 83706-1309
(208) 302-4600
(208) 302-4655
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(082) 367-5170
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
O-1992
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/12/2018
Last updated
06/06/2024
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