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Contact Information

RYAN D HEYBORNE, MD
3025 W CHERRY LANE
MERIDIAN, ID83642
 Phone: 208-302-6400
 Fax: 208-302-6455
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for RYAN D HEYBORNE · (Male)

NPI Number 1659573889
Status Active
Credentials MD
Entity Individual
Enumeration date 06/01/2007
Last updated 07/21/2022 - About 4 years ago
Sole proprietor 1 Yes
Identifiers
  • ID License # M10210
  • IN License # 01062424A
  • ID Medicaid 808011700
Hospital affiliation(s)
  • ST ALPHONSUS REGIONAL MEDICAL CENTER - (Acute Care)
    1055 NORTH CURTIS ROAD
    BOISE, ID 83706
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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