OrganizationActive
Boise Shoulder Clinic, PA
NPI 1760581409 · Orthopaedic Surgery Physician · Eagle, ID
Provider details
- NPI number
- 1760581409
- Entity type
- Organization
- Primary specialty
- Orthopaedic Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Carl Humphrey, Owner(208) 639-4800
- License
- M9563 (ID)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
3381 W Bavaria Street
Eagle, ID 83616-5341
Phone: (208) 639-4800
Fax: (208) 639-4801
Approximate (ZIP-level) locationGet directions
Mailing address
3381 W Bavaria Street
Eagle, ID 83616-5341
Other names (DBA / former)
- Doing business as
- Humphrey Shoulder Clinic
Registry dates
- Enumerated
- 2006-09-21
- Last updated
- 2012-02-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.