Basic Information
| Provider Information | |||||||||
| NPI: | 1528010857 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ORME | ||||||||
| FirstName: | S. | ||||||||
| MiddleName: | KIRBY | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 333 N. 1ST ST. #280 | ||||||||
| Address2: | |||||||||
| City: | BOISE | ||||||||
| State: | ID | ||||||||
| PostalCode: | 83702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2083456545 | ||||||||
| FaxNumber: | 2083451213 | ||||||||
| Practice Location | |||||||||
| Address1: | 333 N. 1ST ST. #280 | ||||||||
| Address2: | |||||||||
| City: | BOISE | ||||||||
| State: | ID | ||||||||
| PostalCode: | 83702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2083456545 | ||||||||
| FaxNumber: | 2083451213 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/16/2006 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208G00000X | M-3186 | ID | Y | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
ID Information
| ID | Type | State | Issuer | Description | 31864 | 01 | ID | BLUE CROSS | OTHER | 000010002256 | 01 | ID | BLUE SHIELD | OTHER | 237701 | 05 | OR | MEDICAID |