Idaho Interventional Pain Center

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

Legal business name

IDAHO INTERVENTIONAL PAIN CENTER

Practice address

8950 W Emerald
Ste 164
Boise, ID 83704

Phone

(208) 323-6273

Fax

(208) 323-6277

NPI assigned

Mar 30, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Richard Alan Dubose, MD

Title

President

Phone

(208) 323-6273

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203379200000",
    "number": "1730140682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8950 W EMERALD",
            "address_2": "STE 164",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83704",
            "telephone_number": "208-323-6273",
            "fax_number": "208-323-6277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8950 W EMERALD",
            "address_2": "STE 164",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83704",
            "telephone_number": "208-323-6273",
            "fax_number": "208-323-6277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO INTERVENTIONAL PAIN CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-30",
        "last_updated": "2008-02-19",
        "status": "A",
        "authorized_official_last_name": "DUBOSE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-323-6273",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pain Medicine Physician in Boise, ID
• Providers in Boise, ID by specialty
• Pain Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.