Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Idaho Eyelid & Facial Plastic Surgery , PLLC

Organization Optometrist · NPI 1255401436

Idaho Eyelid & Facial Plastic Surgery , PLLC is an Optometrist in Boise, Idaho. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
2
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

111 W Main St Ste 200
Boise, ID 83702-7308
Phone: (208) 344-3220
Fax: (208) 344-0461
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Ophthalmology Physician (primary) Taxonomy 207W00000X
Optometrist Taxonomy 152W00000X

Record details

NPI number1255401436
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mark Boerner — Owner · (208) 344-3220
NPI enumeratedNovember 8, 2006
Last updated in NPPESApril 3, 2020
Certification dateApril 3, 2020
Mailing address111 W Main St Ste 200, Boise, ID 83702-7308

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