Irvin E Sackman JR. MD

NPI 1003919473 - Family Medicine - 207Q00000X

NPI Details
NPI 1003919473
Gender Male
Enumeration Date 09/07/2006
Last Updated 08/19/2012
Entity Type Individual
Active Over 10 years ago
Practice Location
130 E BOISE AVE
BOISE ID, 83706, US
Phone (208) 345-4066
Fax (208) 345-4196
Business Location
190 E BANNOCK ST
BOISE ID, 83712-6241, US
Phone (208) 345-4066
Fax (208) 345-4196
Toxanomy
Taxonomy Code 207Q00000X
License State Idaho
License Number M4357
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According to our database, Irvin E Sackman JR. MD NPI is 1003919473, taxonomy code is 207Q00000X and license number is M4357, license state is located at Idaho. Irvin E Sackman JR. MD physically located at 130 E Boise Ave, Boise ID, 83706. NPI Number Irvin E Sackman JR. MD has the Individual type.

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1003919473 NPI number is provided on an as is basis without warranty of any kind. 1003919473 is maintained by the National Plan & Provider Enumeration System. The contents of Irvin E Sackman JR. MD are for informational purposes only.