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

Mark E Kieckbusch, MD

Individual provider Anatomic Pathology & Clinical Pathology Physician · NPI 1215981410

Mark E Kieckbusch, MD is an Anatomic Pathology & Clinical Pathology Physician in Boise, Idaho. Licensed in Idaho. Registered with an NPI since 2006.

Licensed in
ID
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

190 E Bannock St
Boise, ID 83712-6241
Phone: (208) 381-2367
Fax: (208) 381-4762
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anatomic Pathology & Clinical Pathology Physician (primary) Taxonomy 207ZP0102X · Licence M6070 (ID)
Hematology (Pathology) Physician Taxonomy 207ZH0000X · Licence M6070 (ID)

Record details

NPI number1215981410
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 20, 2006
Last updated in NPPESDecember 11, 2007
Mailing addressPo Box 9589, Boise, ID 83707-4589

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