Provider Demographics
NPI:1891731014
Name:TROTTA, FRANCOIS D (MD, PA)
Entity Type:Individual
Prefix:
First Name:FRANCOIS
Middle Name:D
Last Name:TROTTA
Suffix:
Gender:M
Credentials:MD, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 E MALLARD DR
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83706-3975
Mailing Address - Country:US
Mailing Address - Phone:208-323-8660
Mailing Address - Fax:
Practice Address - Street 1:128 E MALLARD DR
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706-3975
Practice Address - Country:US
Practice Address - Phone:208-323-8660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2013-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM6094207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C78380Medicare UPIN