| State Of Idaho | |
|
1660 11th Ave N, Nampa, ID 83687-5000 | |
| (208) 442-2812 | |
| (208) 467-5978 |
| Full Name | State Of Idaho |
|---|---|
| Type | Facility |
| Speciality | Podiatrist |
| Location | 1660 11th Ave N, Nampa, Idaho |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588780449 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213E00000X | Podiatrist | (* (Not Available)) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| State Of Idaho 1660 11th Ave N, Nampa, ID 83687-5000 Ph: (208) 442-2812 | State Of Idaho 1660 11th Ave N, Nampa, ID 83687-5000 Ph: (208) 442-2812 |
Troy W. Fowler, D.P.M. Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 203 12th Ave Rd, Nampa, ID 83686 Phone: 208-466-3338 Fax: 208-466-3554 | |
Phillip Neil Burk, D.P.M. Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 203 12th Ave Rd, Suite A, Nampa, ID 83686 Phone: 208-466-3338 Fax: 208-466-3554 |