NPI 1760825442 · live from the CMS NPI Registry
Jason Gary Hamblin, M.D.
Radiology, Diagnostic Radiology in Boise, ID. National Provider Identifier 1760825442, active.
NPI record
| NPI | 1760825442 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Radiology, Diagnostic Radiology 2085R0202X |
| Practice location | 1055 N Curtis Rd, Boise, ID 83706 |
| Practice phone | 208-367-8855 |
| Mailing address | 933 Bradbury Dr Se, Suite 2222, Albuquerque, NM 87106 |
| Enumerated | April 11, 2013 |
| Last updated | December 4, 2019 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | RS2013-0428 (NM) |
| Student in an Organized Health Care Education/Training Program | 390200000X | — (NM) |
| Radiology, Diagnostic Radiology primary | 2085R0202X | MD2015-0702 (NM) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.