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General NPI Number Information
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NPI Number | 1700040532
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Entity Type | Organization
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Legal Business Name | LINDIE BORTON M.D. PA
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Dates
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Enumeration Date | 07/10/2008
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 3811 N GARDEN CENTER WAY
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City | BOISE
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State | ID
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Zip | 83703-5007
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Country | US
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Telephone | 208-287-5525
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Fax | 208-287-5530
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Provider Business Mailing Address
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Address Line | 3811 N GARDEN CENTER WAY
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City | BOISE
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State | ID
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Zip | 83703-5007
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Country | US
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Telephone | 208-287-5525
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Fax | 208-287-5530
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MR. ALEXANDER D ABEL
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Credential |
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Telephone | 208-287-5525
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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 | M62227
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License Number State | ID
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