| Treasure Valley Endocrinology Pc | |
|
900 N Liberty St Ste 201 Boise ID 83704-8707 | |
| (208) 367-6740 | |
| (208) 367-6742 |
| Full Name | Treasure Valley Endocrinology Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 900 N Liberty St Ste 201, Boise, Idaho |
| Authorized Official Name and Position | Julie A. Foote (ENDOCRINOLOGIST) |
| Authorized Official Contact | 2083676740 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Treasure Valley Endocrinology Pc Po Box 4143 Boise ID 83711-4143 Ph: (208) 367-6740 | Treasure Valley Endocrinology Pc 900 N Liberty St Ste 201 Boise ID 83704-8707 Ph: (208) 367-6740 |
| NPI Number | 1417967696 |
|---|---|
| Provider Enumeration Date | 08/09/2006 |
| Last Update Date | 06/19/2008 |
| Medicare PECOS PAC ID | 0042237117 |
|---|---|
| Medicare Enrollment ID | O20051027000967 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417967696 | NPI | - | NPPES |
| 807326100 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | M 6551 (Illinois) | Primary |
| Provider Name | Tiffany C Heidt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689683518 PECOS PAC ID: 0547247603 Enrollment ID: I20051031000104 |
| Provider Name | Julie A Foote |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1104836303 PECOS PAC ID: 3476570540 Enrollment ID: I20051031000112 |
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