Hlavinka, Jon L
Hlavinka, Jon L is an individual health care provider with primary practice located at 300 E Bannock St , Boise ID 83712-6207. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Hlavinka, Jon L can be contacted via phone (208) 342-7400.Contact Information
Primary practice address
300 E Bannock St
Boise ID 83712-6207
Phone: (208) 342-7400
Fax: (208) 342-7400
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | M6008 | Idaho |
Profile Details
| NPI number | 1194715136 |
|---|---|
| LBN Legal business name | Hlavinka, Jon L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 21st, 2005 |
| Last updated | Mar 29th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194715136 | NPPES |
| Idaho | MEDICAID | 002364500 | |
| Idaho | Other | 105443 | |
| Idaho | Other | 000010004642 | |
| Idaho | Other | 806359300 |
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