| NPI Details | |
|---|---|
| NPI | 1073554804 |
| Gender | Male |
| Enumeration Date | 06/10/2006 |
| Last Updated | 07/08/2007 |
| Entity Type | Individual |
| Active | Over 11 years ago |
| Practice Location | |
|---|---|
| 190 E BANNOCK ST BOISE ID, 83712-6241, US |
|
| Phone | (208) 381-2222 |
| Fax | |
| Business Location | |
|---|---|
| 190 E BANNOCK ST BOISE ID, 83712-6241, US |
|
| Phone | (208) 381-2222 |
| Fax | |
| Toxanomy | |
|---|---|
| Taxonomy Code | 207P00000X |
| License State | Idaho |
| License Number | M7494 |
| Remove 1073554804 NPI Number | |
According to our database, L Tad Cowley MD NPI is 1073554804, taxonomy code is 207P00000X and license number is M7494, license state is located at Idaho. L Tad Cowley MD physically located at 190 E Bannock St, Boise ID, 83712-6241. NPI Number L Tad Cowley MD has the Individual type.
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1073554804 NPI number is provided on an as is basis without warranty of any kind. 1073554804 is maintained by the National Plan & Provider Enumeration System. The contents of L Tad Cowley MD are for informational purposes only.
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