Individual
TOM FACISZEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4850 N ROSEPOINT WAY, SUITE 100, BOISE, ID 83713-5262
(208) 475-0899
Mailing address
4850 N ROSEPOINT WAY, SUITE 100, BOISE, ID 83713-5262
(208) 475-0899
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
M-12458
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31890900
—
WI
Enumeration date
08/31/2006
Last updated
03/08/2017
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