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General NPI Number Information
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NPI Number | 1164218269
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Entity Type | Organization
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Legal Business Name | APEX ADVANCED SPINE & PAIN PLLC
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Dates
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Enumeration Date | 04/16/2025
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Last Update Date | 06/15/2025
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Provider Practice Location Address
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Address Line | 2960 E ST LUKES ST
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City | MERIDIAN
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State | ID
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Zip | 83642
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Country | US
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Telephone | 208-992-4111
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Fax |
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Provider Business Mailing Address
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Address Line | 10400 W OVERLAND RD UNIT 287
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City | BOISE
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State | ID
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Zip | 83709-1433
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Country | US
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Telephone | 303-903-8003
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JASON WILLIAMS
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Credential | MD
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Telephone | 303-903-8003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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