Healthcare Provider Details

I. General information

NPI: 1902720055
Provider Name (Legal Business Name): IRONWOOD SURGICAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8854 W EMERALD ST STE 270
BOISE ID
83704-4859
US

IV. Provider business mailing address

3430 E CHINDEN BLVD
EAGLE ID
83616-6475
US

V. Phone/Fax

Practice location:
  • Phone: 208-671-9001
  • Fax:
Mailing address:
  • Phone: 717-578-0783
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LEAH STOCKTON
Title or Position: OWNER
Credential: MD
Phone: 208-671-9001