| Charles E Boult, MD | |
|
5966 W Curtisian Ave, Boise, ID 83706 | |
| (208) 302-5400 | |
| (208) 302-5455 |
| Full Name | Charles E Boult |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine - Geriatric Medicine |
| Location | 5966 W Curtisian Ave, Boise, Idaho |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962468025 | NPI | - | NPPES |
| 687003100 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | D57945 (Maryland) | Secondary |
| 207RG0300X | Internal Medicine - Geriatric Medicine | M-13173 (Idaho) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Charles E Boult, MD 3340 E Goldstone Way, Meridian, ID 83642-1026 Ph: (208) 302-5400 | Charles E Boult, MD 5966 W Curtisian Ave, Boise, ID 83706 Ph: (208) 302-5400 |
Dr. Jennifer A Hofstra, MD Geriatric Medicine Medicare: Accepting Medicare Assignments Practice Location: 1055 N Curtis Road, Boise, ID 83706 Phone: 757-446-8920 Fax: 757-446-5242 | |
Dr. James Robert Polk, MD Geriatric Medicine Medicare: Not Enrolled in Medicare Practice Location: 1055 N Curtis Rd, Boise, ID 83706 Phone: 208-367-3104 | |
Dr. Michael Frederic Krug, M.D. Geriatric Medicine Medicare: Medicare Enrolled Practice Location: 190 E Bannock St, Boise, ID 83712 Phone: 208-381-5015 Fax: 208-381-1873 | |
Derrel V Walker, M.D. Geriatric Medicine Medicare: Medicare Enrolled Practice Location: 1055 N Curtis Road, Boise, ID 83706 Phone: 208-367-7350 Fax: 208-367-3951 | |
Dr. Janat E. O'donnell, MD Geriatric Medicine Medicare: Medicare Enrolled Practice Location: 500 W. Fort St., # 111, Boise, ID 83702 Phone: 208-422-1325 Fax: 208-422-1319 | |
Carl L Durning, MD Geriatric Medicine Medicare: Not Enrolled in Medicare Practice Location: 6094 W Emerald St, Boise, ID 83704 Phone: 208-367-6575 Fax: 208-367-6597 | |
Dr. Christopher J Goulet, M.D. Geriatric Medicine Medicare: Accepting Medicare Assignments Practice Location: 6259 W Emerald St, Boise, ID 83704 Phone: 208-489-1900 Fax: 208-375-5286 |