NPI 1114412731

Victory Surgical Services PLLC

Organisation Surgery Physician Boise, ID

Practice location

Address: 8854 W Emerald St STE 140, Boise, ID 83704
Phone: (208) 321-4790
Fax: (208) 321-4836
Mailing address: 8854 W Emerald St STE 140, Boise, ID 83704-4845

Authorised official

Name: Keri L Hine
Title: Administrator
Phone: (208) 321-4790

Registered specialties

Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208600000X

Other Surgery providers in Idaho →

Registry record

NPI: 1114412731
Entity type: Organization
NPI issued: 26 Jun 2018
Record last updated: 30 Aug 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.