Healthcare Provider Details

I. General information

NPI: 1548276165
Provider Name (Legal Business Name): DR. WILLIAM STANO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 W JEFFERSON ST
BOISE ID
83702-6044
US

IV. Provider business mailing address

220 W JEFFERSON ST
BOISE ID
83702-6044
US

V. Phone/Fax

Practice location:
  • Phone: 208-343-8907
  • Fax: 208-343-9161
Mailing address:
  • Phone: 208-343-8907
  • Fax: 208-343-9161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. WILLIAM STANO
Title or Position: ADMINISTRATOR
Credential: DPM
Phone: 208-343-8907