Healthcare Provider Details

I. General information

NPI: 1649212077
Provider Name (Legal Business Name): JOSEPH A HILINSKI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 09/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 E JEFFERSON ST
BOISE ID
83712-6273
US

IV. Provider business mailing address

305 E JEFFERSON ST
BOISE ID
83712-6273
US

V. Phone/Fax

Practice location:
  • Phone: 208-381-7330
  • Fax: 208-381-7331
Mailing address:
  • Phone: 208-381-7330
  • Fax: 208-381-7331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License Number046121
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: