Tanner Holyoak
Internal Medicine in Boise, ID. Individual provider (NPI-1).
NPI number1164224903
StatusActive
Last updated in NPPESJun 26, 2025
Details
- NPI
- 1164224903
- Entity type
- Individual (NPI-1)
- Name
- Tanner Holyoak
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 25, 2025
- Certification date
- Jun 26, 2025
- Last updated
- Jun 26, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | 6071460 | ID | Yes |
Practice location
500 W Fort St # 111rBoise, ID 83702-4501
Phone 208-422-1000
Mailing address
500 W Fort St # 111rBoise, ID 83702-4501
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