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NPI Code Detail

MEDICARE: MRS. JAIYEOLA A. ASHAYE MD

MEDICARE: MRS. JAIYEOLA A. ASHAYE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianM8683ID

General Provider Information

NPI Number : 1952488561
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JAIYEOLA A. ASHAYE MD
Provider Business Mailing Address
First Line : 190 E BANNOCK ST
Second Line :
City : BOISE
State : ID
Zip : 83712-6241
Country : US
Telephone Number : 208-381-2222
Fax Number :
Provider Business Practice Location Address
First Line : 824 S DIAMOND ST
Second Line :
City : NAMPA
State : ID
Zip : 83686-5960
Country : US
Telephone Number : 208-465-6940
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 09/17/2012

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