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BOISE GASTROENTEROLOGY ASSOCIATES

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Company Details

Name: BOISE GASTROENTEROLOGY ASSOCIATES
Jurisdiction: Idaho
Legal type: Assumed Business Name
Status: Active-Current
Date of registration: 04 Jan 2007 (18 years ago)
Entity Number: 329562
Place of Formation: IDAHO
File Number: 0000329562
ZIP code: 83704
County: Ada County
Mailing Address: 6259 W EMERALD ST BOISE, ID 83704

National Provider Identifier

NPI Number:
1023228558

Authorized Person:

Name:
DR. ROBERT F GIBSON
Role:
PHYSICIAN
Phone:

Taxonomy:

Selected Taxonomy:
261QA1903X - Ambulatory Surgical Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
2083755286

Filing

Filing Name Filing Number Filing date
Initial Filing 0000329562 2007-01-04

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Date of last update: 24 Sep 2024

Sources: Idaho Secretary of State