Healthcare Provider Details

I. General information

NPI: 1124060447
Provider Name (Legal Business Name): WILLIAM G BINEGAR MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 03/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 W MYRTLE ST
BOISE ID
83702-7656
US

IV. Provider business mailing address

301 W MYRTLE ST
BOISE ID
83702-7656
US

V. Phone/Fax

Practice location:
  • Phone: 208-342-8200
  • Fax:
Mailing address:
  • Phone: 208-342-8200
  • Fax: 208-342-8202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM G BINEGAR
Title or Position: PRESIDENT
Credential: MD
Phone: 208-342-8200