Organization
STANLEY J. WATERS MD
Active
Other names
AMERICANA ORTHOPAEDICS
Organization subpart
No
Provider details
NPI number
Authorized official
STANLEY J WATERS M.D., PH.D. (OWNER)
(208) 322-0485
Entity
Organization
Contact information
Practice address
1673 SHORELINE DR, STE 100, BOISE, ID 83702-6736
(208) 322-0485
(208) 378-8228
Mailing address
1673 SHORELINE DR, STE 100, BOISE, ID 83702-6736
(208) 322-0485
(208) 378-8228
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
M6247
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8J893
BLUE CROSS GROUP #
ID
Enumeration date
05/05/2006
Last updated
05/05/2015
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