Organization
CAPITAL SURGICAL ASSOCIATES, PA
Active
Other names
Orthopaedic Associates, PA
Organization subpart
No
Provider details
NPI number
Authorized official
LISA JACK (PRACTICE MANAGER)
(208) 321-4790
Entity
Organization
Contact information
Practice address
8854 W EMERALD ST, SUITE 140, BOISE, ID 83704-4845
(208) 321-4790
(208) 321-4836
Mailing address
8854 W EMERALD ST STE 140, BOISE, ID 83704-4845
(208) 321-4790
(208) 321-4836
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
—
208600000X
Surgery Physician
Primary
—
—
208800000X
Urology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13D2290127
CLIA
ID
01
—
290408
REGENCE BLUE SHIELD
ID
05
—
807082700
—
ID
01
—
89466
BLUE CROSS
ID
01
—
DC4854
TRAVELERS MEDICARE
ID
Enumeration date
05/05/2006
Last updated
08/28/2025
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