NPI 1366607996

Retina Specialists of Idaho, PLLC

Organisation Ophthalmology Physician Boise, ID

Practice location

Address: 13923 W Wainwright Dr Suite 301, Boise, ID 83713-1969
Phone: (208) 938-5624
Fax: (208) 938-5764

Authorised official

Name: Denton R. Roberts
Title: Owner
Phone: (208) 938-5624

Registered specialties

Ophthalmology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207W00000X Licence M-10066 (ID)

Other Ophthalmology providers in Idaho →

Registry record

NPI: 1366607996
Entity type: Organization
NPI issued: 23 Jul 2008
Record last updated: 10 Apr 2012

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.