Organization
INTERMOUNTAIN ORTHOPAEDICS SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT R BROWN (ADMINISTRATOR)
(208) 489-4229
Entity
Organization
Contact information
Practice address
600 N ROBBINS RD, STE 100, BOISE, ID 83702-4539
(208) 383-0201
(208) 489-4300
Mailing address
600 N ROBBINS RD, STE 401, BOISE, ID 83702-4539
(208) 383-0201
(208) 489-4300
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010006178
BLUE SHIELD
ID
05
—
002683100
—
ID
05
—
805467800
—
ID
01
—
88815
BLUE CROSS OF IDAHO
ID
01
—
CK7632
MEDICARE RAILROAD
ID
01
—
CN7062
MEDICARE RAILROAD
ID
Enumeration date
08/23/2006
Last updated
09/08/2008
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