Most Relevant Information
Provider Data
| NPI Number: | 1003819459 |
| Provider Name: | MARK J BOERNER M.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 207W00000X |
| Specialty: | Ophthalmology |
| License Number: | M7206 |
Most Important Dates
| Enumeration Date: | 05/31/2005 |
| Last Updated: | 04/15/2020 |
Provider Practice Location
111 W MAIN ST STE 200
BOISE
ID
837027308
Practice Location Phone/Fax
| Phone: | 2083443220 |
| Fax: | 2083440461 |
Provider Mailing Location
111 W MAIN ST
STE 200
BOISE
ID
837027308
Provider Mailing Phone/Fax
| Phone: | 2083443220 |
| Fax: | 2083440461 |