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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MARK E KIECKBUSCH, M.D.

Active

Anatomic Pathology & Clinical Pathology · BOISE, ID

Registration Details

NPI Number
1215981410
Provider Type
Individual
Gender
Male
NPI Issued
May 20, 2006 (19.930526220694 yrs)
Last Updated
Dec 11, 2007
Licenses
M6070 (ID)
M6070 (ID)

Practice Information

Address
190 E BANNOCK ST
BOISE, ID, 837126241
Browse ID providers · Browse ZIP 83712
Phone
2083812367
Fax
2083814762
Primary Specialty
Anatomic Pathology & Clinical Pathology
207ZP0102X
Additional Specialty
Hematology (Pathology)

Other Anatomic Pathology & Clinical Pathology Providers in BOISE, ID

Name Credential NPI
MICHAEL J MYHRE M.D. 1821093527
DR. C. MANUEL SUAREZ M.D. 1992701353
DANIEL J WALSH M.D. 1376597575
NANCY C KOIS M.D. 1356397491
RICHARD A STILLINGER M.D. 1750329025
MICHAEL J CAREY M.D. 1881632065
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.