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Individual

KARA MACKENZIE KUNTZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
5966 W CURTISIAN ROAD, BOISE, ID 83704
(208) 302-5400
(208) 302-5455
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 302-5400
(208) 302-5455

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
M-12220
ID
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
M-12220
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1891057246
ID
Enumeration date
06/12/2012
Last updated
09/28/2016
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