Healthcare Provider Details

I. General information

NPI: 1306843693
Provider Name (Legal Business Name): JAMES MCGHEE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/01/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

727 E RIVERPARK LN STE 100
BOISE ID
83706-4097
US

IV. Provider business mailing address

727 E RIVERPARK LN STE 100
BOISE ID
83706-4097
US

V. Phone/Fax

Practice location:
  • Phone: 208-388-8900
  • Fax: 208-388-8907
Mailing address:
  • Phone: 208-388-8900
  • Fax: 208-388-8907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberM8884
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: