Jesse Mix, DO

NPI 1538415351 · on the registry since 2012

Practice

Address: 500 W Fort St
# 111
Boise, ID 83702
Phone: (208) 422-1000
Fax: (208) 422-1319
Organisation at this address: Vamc
Boise Vamc
Boise Vamc
Boise Va Hospital
Veteran'S Administration Medical Center
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 674

Registry record

Primary taxonomy: 207Q00000X
207Q00000X
Also registered as: 207Q00000X
Licence states on file: AZ, ID
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2022-02-25

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho