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General NPI Number Information
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NPI Number | 1225011893
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Entity Type | Individual
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Provider Name | ERIC T GARNER M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/28/2005
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Last Update Date | 06/01/2010
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Provider Practice Location Address
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Address Line | 900 N LIBERTY ST STE 400
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City | BOISE
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State | ID
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Zip | 83704-8704
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Country | US
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Telephone | 208-367-3320
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Fax | 208-367-7474
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Provider Business Mailing Address
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Address Line | 900 N LIBERTY ST STE 400
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City | BOISE
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State | ID
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Zip | 83704-8704
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Country | US
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Telephone | 208-367-3320
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Fax | 208-367-7474
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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 | 207YX0905X
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Taxonomy Name | Otolaryngology/Facial Plastic Surgery Physician
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License Number | M5636
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License Number State | ID
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