Richard Dallin Boardman (NPI# 1346764511, PAC ID# 3678820479) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OPTOMETRY.
| Nation Provider ID (NPI) | 1346764511 |
| PAC ID by PECOS | 3678820479 |
| Professional Enrollment ID | I20180725002124 |
| Full Name | Richard Dallin Boardman |
| Organization Legal Name | LWK, P.C. |
| Address |
4013 Yellowstone Ave Suite D Chubbuck ID 83202-1984 |
| Phone Number | 2082977019 |
| Gender | M |
| Medical School | PACIFIC UNIVERSITY - COLLEGE OF OPTOMETRY |
| Graduation Year | 2018 |
| Primary Specialty | OPTOMETRY |
| Group Practice PAC ID | 5890824247 |
| Number of Group Practice Members | 12 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 291 N Milwaukee St A, Suite 3, Boise, ID 83704-9132 | LWK, P.C. | |
| 4013 Yellowstone Ave, Suite D, Chubbuck, ID 83202-1984 | 2082977019 | LWK, P.C. |
| 810 S 100, Suite A, Logan, UT 84321-5929 | 4357877200108 | LOGAN EYE INSTITUTE, PLLC |
| Organization Legal Name | LWK, P.C. |
| Physicians | 11 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christine Chong | Optometry | Lwk, P.C. | 16448 N Midland Blvd, Nampa, ID 83687-5222 |
| Kacey D Blaylock | Optometry | Lwk, P.C. | 291 N Milwaukee St A, Suite 3, Boise, ID 83704-9132 |
| Lavar W Kofoed | Optometry | Lwk, P.C. | 4013 Yellowstone Ave, Suite D, Chubbuck, ID 83202-1984 |
| Jay A Hartwell | Optometry | Lwk, P.C. | 1605 A Blue Lakes Blvd N, Twin Falls, ID 83301-3374 |
| Daniel G Nielson | Optometry | Lwk, P.C. | 4013 Yellowstone Ave, Suite D, Chubbuck, ID 83202-1984 |
| Gerald L Cates | Optometry | Lwk, P.C. | 291 N Milwaukee St A, Suite 3, Boise, ID 83704-9132 |
| Jaimen Lee Dixon | Optometry | Lwk, P.C. | 291 N Milwaukee St A, Suite 3, Boise, ID 83704-9132 |
| Erik T Thompson | Optometry | Lwk, P.C. | 16448 N Midland Blvd, Nampa, ID 83687-5222 |
| Alan R Smith | Optometry | Lwk, P.C. | 291 N Milwaukee St A, Suite 3, Boise, ID 83704-9132 |
| Scott D Hansen | Optometry | Lwk, P.C. | 16448 N Midland Blvd, Nampa, ID 83687-5222 |
| Street Address |
4013 YELLOWSTONE AVE SUITE D |
| City | CHUBBUCK |
| State | ID |
| Zip | 83202-1984 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lavar W Kofoed | Optometry | Lwk, P.C. | 4013 Yellowstone Ave, Suite D, Chubbuck, ID 83202-1984 |
| Daniel G Nielson | Optometry | Lwk, P.C. | 4013 Yellowstone Ave, Suite D, Chubbuck, ID 83202-1984 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Scott Bradley Schaffer | Nurse Practitioner | 476 E Chubbuck Rd, Chubbuck, ID 83202-1816 | |
| Brittany Strong | Nurse Practitioner | Need-a-nurse Medical Staffing, LLC | 476 E Chubbuck Rd, Chubbuck, ID 83202-1816 |
| David P Brizzee | Family Medicine | 2010 Flandro Dr, Pocatello, ID 83202-1947 | |
| Nathan J Evans | Chiropractic | 2010 Flandro Dr, Pocatello, ID 83202-1947 | |
| Trevor Jack Batty | Dermatology | Stoddard Medical Inc | 147 W Chubbuck Rd, Chubbuck, ID 83202-2314 |
| Ryan T Mcculloch | Physician Assistant | Stoddard Medical Inc | 147 W Chubbuck Rd, Chubbuck, ID 83202-2314 |
| Earl R Stoddard | Dermatology | Stoddard Medical Inc | 147 W Chubbuck Rd, Chubbuck, ID 83202-2314 |
| Leslie I Burnside | Physician Assistant | Stoddard Medical Inc | 147 W Chubbuck Rd, Chubbuck, ID 83202-2314 |
| Amy L Mckinlay | Physician Assistant | Stoddard Medical Inc | 147 W Chubbuck Rd, Chubbuck, ID 83202-2314 |
| Sandra L Vollmer | Clinical Social Worker | T Help | 4737 S Afton Pl, Suite A, Chubbuck, ID 83202-2317 |
| Find all physicians in zip 83202 | |||
| City | CHUBBUCK |
| Zip Code | 83202 |
| Specialty | OPTOMETRY |
| City + Specialty | CHUBBUCK + OPTOMETRY |
Please comment or provide details below to improve the information on Richard Dallin Boardman.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.