Organization
IDAHO NEUROLOGICAL SURGERY, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS E. SMITH M. D. (PRESIDENT/OWNER/NEUROSURGEON)
(208) 344-1000
Entity
Organization
Contact information
Practice address
222 N. 2ND STREET, SUITE 307, BOISE, ID 83702-6131
(208) 344-1000
(208) 344-1331
Mailing address
222 N. 2ND STREET, SUITE 307, BOISE, ID 83702-6131
(208) 344-1000
(208) 344-1331
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
M-3522
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002755500
—
ID
Enumeration date
10/23/2007
Last updated
10/23/2007
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