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8955 W Hackamore Dr, Boise, ID 83709 | |
(208) 344-7944 | |
(208) 343-4676 |
Full Name | |
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Type | Facility |
Speciality | Ophthalmology |
Location | 8955 W Hackamore Dr, Boise, Idaho |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1326550096 | NPI | - | NPPES |
1942316054 | Medicaid | ID | |
1326302548 | Medicaid | ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
207W00000X | Ophthalmology | (* (Not Available)) | Primary |
Provider Name | Alan R Smith |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1942316054 PECOS PAC ID: 9739478835 Enrollment ID: I20160512001374 |
Provider Name | Joshua E Mcadams |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1326302548 PECOS PAC ID: 3779734272 Enrollment ID: I20171129001437 |
Mailing Address | Practice Location Address |
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8955 W Hackamore Dr, Boise, ID 83709 Ph: (208) 344-7944 | 8955 W Hackamore Dr, Boise, ID 83709 Ph: (208) 344-7944 |