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General NPI Number Information
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NPI Number | 1518490283
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Entity Type | Individual
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Provider Name | JAMES ABBOTT MD
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Gender | Male
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Dates
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Enumeration Date | 04/09/2017
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 100 HOSPITAL DR SUITE 201
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City | KETCHUM
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State | ID
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Zip | 83340
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Country | US
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Telephone | 208-725-2171
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Fax | 208-725-2015
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Provider Business Mailing Address
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Address Line | 190 E BANNOCK ST
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City | BOISE
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State | ID
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Zip | 83712-6241
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Country | US
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Telephone |
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Fax |
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 1871360
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 207ND0900X
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Taxonomy Name | Dermatopathology Physician
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License Number | MED-PHYS-LIC-109898
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License Number State | MT
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Taxonomy #3
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | MED-PHYS-LIC-109898
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License Number State | MT
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Taxonomy #4
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 10955715-1205
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License Number State | UT
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