<Unavail>

LBN: Bryan C Pogue Md
<Unavail> is an health care organization with primary practice located at 6565 W Emerald St , Boise ID 83704-8737. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Bryan C Pogue Md can be contacted via phone (208) 377-5055, or through Sizemore, Kelli M via phone (208) 377-5055.

Contact Information

Primary practice address
6565 W Emerald St Boise ID 83704-8737
Phone: (208) 377-5055
Fax: (208) 377-5335
Website:
Map and Directions
Authorized official contact:
Name: Sizemore, Kelli M CMPE
Phone: (208) 377-5055

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X M5125 Idaho

Profile Details

NPI number 1477558328
LBN Legal business name Bryan C Pogue Md
DBA Doing business as <Unavail>
Authorized official Sizemore, Kelli M CMPE
Entity Organization
Organization subpart 1 No
Enumeration date Jun 16th, 2005
Last updated Apr 5th, 2016 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477558328 NPPES
Idaho MEDICAID 002789800

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