Provider Demographics
NPI:1487655379
Name:BOES, DAVID A (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:BOES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2800 11TH AVE S
Mailing Address - Street 2:SUITE 14
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-5263
Mailing Address - Country:US
Mailing Address - Phone:406-455-2020
Mailing Address - Fax:406-771-6816
Practice Address - Street 1:2800 11TH AVE S
Practice Address - Street 2:SUITE 14
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-5263
Practice Address - Country:US
Practice Address - Phone:406-455-2020
Practice Address - Fax:406-771-6816
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-02
Last Update Date:2012-02-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MT7544207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0104442Medicaid
MT010000761Medicare ID - Type Unspecified
MT0104442Medicaid