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General NPI Number Information
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NPI Number | 1114119955
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Entity Type | Organization
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Legal Business Name | ORTHOPEDIC AMBULATORY ANESTHESIA PA
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Dates
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Enumeration Date | 08/15/2007
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Last Update Date | 05/20/2010
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Provider Practice Location Address
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Address Line | 1425 W RIVER ST
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City | BOISE
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State | ID
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Zip | 83702-6861
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Country | US
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Telephone | 208-342-1932
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 904
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City | BOISE
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State | ID
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Zip | 83701-0904
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Country | US
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Telephone | 503-372-2740
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Fax | 503-372-2755
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MARGARET HALDIS KASPAR
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Credential | MD
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Telephone | 208-939-4704
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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