Botkin, Gregory T

Botkin, Gregory T is an individual health care provider with primary practice located at 6640 Kaniksu St , Bonners Ferry ID 83805-7532. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Botkin, Gregory T can be contacted via phone (208) 267-3141.

Contact Information

Primary practice address
6640 Kaniksu St Bonners Ferry ID 83805-7532
Phone: (208) 267-3141
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X M-7205 Idaho

Profile Details

NPI number 1346341351
LBN Legal business name Botkin, Gregory T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 25th, 2006
Last updated Mar 7th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346341351 NPPES
Idaho Other M-7205 STATE LICENSE
Idaho MEDICAID 1346341351 STATE LICENSE
Idaho Other CS-7048 STATE LICENSE

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