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General NPI Number Information
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NPI Number | 1124151188
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Entity Type | Individual
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Provider Name | JOSEPH F BOERO MD
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Gender | Male
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 10/19/2011
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Provider Practice Location Address
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Address Line | 1155 4TH AVE S
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City | PARK FALLS
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State | WI
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Zip | 54552-1922
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Country | US
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Telephone | 715-762-2970
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Fax | 715-762-2981
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Provider Business Mailing Address
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Address Line | PO BOX 263
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City | PARK FALLS
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State | WI
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Zip | 54552-0263
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Country | US
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Telephone | 715-762-2970
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Fax | 715-762-2981
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 33233
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License Number State | WI
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