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Contact Information

PARK CENTER FOOT AND ANKLE
671 E. RIVERPARK LANE
STE 110
BOISE, ID83706
 Phone: 208-387-0900
 Fax: 208-345-5883
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for PARK CENTER FOOT AND ANKLE · (Female)

NPI # 1629043252
Status Active
Credentials
Entity Individual
Enumeration date 02/17/2006
Last updated 11/13/2023 - About 3 years ago
Sole proprietor 1 Not specified
Identifiers
  • ID License # P142
  • ID Medicaid 002725800
  • Other DA8994 RAILROAD MEDICARE
  • ID Other P1423 BLUE CROSS OF ID
  • ID Other 000010015660 REGENCE BS OF ID
Hospital affiliation(s) Not Available
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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