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General NPI Number Information
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NPI Number | 1932762275
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Entity Type | Individual
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Provider Name | THOMAS JAMES NORTH
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Gender | Male
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Dates
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Enumeration Date | 04/22/2019
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 3301 N SAWGRASS WAY
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City | BOISE
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State | ID
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Zip | 83704-4493
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Country | US
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Telephone | 208-375-0862
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Fax | 208-375-2658
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MED-PHYS-LIC-114770
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 9871557
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License Number State | ID
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