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General NPI Number Information
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NPI Number | 1235046731
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Entity Type | Organization
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Legal Business Name | IDAHO PAIN ASSOCIATES PLLC
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Dates
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Enumeration Date | 08/27/2026
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Last Update Date | 08/27/2026
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Provider Practice Location Address
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Address Line | 100 COTTONWOOD CT # D150
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City | EAGLE
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State | ID
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Zip | 83616-6576
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Country | US
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Telephone | 208-917-2713
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Fax | 208-955-2029
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Provider Business Mailing Address
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Address Line | 100 COTTONWOOD CT # D150
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City | EAGLE
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State | ID
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Zip | 83616-6576
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Country | US
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Telephone | 208-917-2713
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Fax | 208-955-2029
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Authorized Official
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Title or Position | PARTNER
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Name | JOSHUA COLEMAN
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Credential | CRNA
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Telephone | 951-264-2258
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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