Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. MARK J BOERNER, M.D.
Deactivated Sole ProprietorOphthalmology · BOISE, ID
This NPI has been deactivated.
The record was deactivated on March 20, 2006.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1003819459
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 31, 2005 (0.8027397260274 yrs)
- Last Updated
- Apr 15, 2020
- Deactivated
- Mar 20, 2006
- License
-
M7206 (ID)
- Sole Proprietor
- Yes
Practice Information
- Address
-
111 W MAIN ST STE 200BOISE, ID, 837027308Browse ID providers · Browse ZIP 83702
- Phone
- 2083443220
- Fax
- 2083440461
- Primary Specialty
-
Ophthalmology
207W00000X
Other Ophthalmology Providers in BOISE, ID
| Name | Credential | NPI |
|---|---|---|
| MARK E HOLLINGSHEAD | M.D. | 1689670911 |
| JOHN R SONNTAG | M.D. | 1245223809 |
| DENTON R ROBERTS | MD | 1699742395 |
| ADAM C REYNOLDS | M.D. | 1417916586 |
| DR. SCOTT ALAN LARSON | MD | 1992757991 |
| JON R FISHBURN | MD | 1639123490 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.