Organization
TIMOTHY J JOHANS, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY J JOHANS MD (OWNER)
(208) 327-5600
Entity
Organization
Contact information
Practice address
6140 W CURTISIAN AVE STE 400, BOISE, ID 83704-8907
(208) 327-5600
(208) 327-5602
Mailing address
6140 W CURTISIAN AVE STE 400, BOISE, ID 83704-8907
(208) 327-5600
(208) 327-5602
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
M6183
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010004934
REGENCE BLUE SHEILD OF ID
ID
05
—
1942330204
—
ID
01
—
194498
OMAP
OR
01
—
8K248
BLUE CROSS OF IDAHO
ID
Enumeration date
03/06/2007
Last updated
05/09/2022
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