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General NPI Number Information
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NPI Number | 1609805779
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Entity Type | Organization
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Legal Business Name | ADA PEDIATRICS, P.A.
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Dates
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Enumeration Date | 07/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 650 N COLE RD
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City | BOISE
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State | ID
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Zip | 83704-9117
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Country | US
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Telephone | 208-323-1222
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Fax | 208-323-1825
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Provider Business Mailing Address
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Address Line | 650 N COLE RD
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City | BOISE
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State | ID
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Zip | 83704-9117
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Country | US
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Telephone | 208-323-1222
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Fax | 208-323-1825
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT E LINDSAY
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Credential | M.D.
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Telephone | 208-323-1222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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