Individual provider · Type 1 NPI

John Charles Fogg Ii

Gastroenterology Registered Nurse · Boise, ID

NPI number 1396368601 Active

Practice location

500 W Fort St
Boise, ID 83702-4501

Mailing address

7080 W Ambleside Dr
Boise, ID 83709-4901

Specialties and licenses

TaxonomyCodeLicense
Gastroenterology Registered Nurse Primary 163WG0100X31358 (ID)

Gastroenterology Registered Nurse: Definition to come...

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About NPI 1396368601

John Charles Fogg Ii's National Provider Identifier is 1396368601, issued on May 20, 2020. The primary taxonomy on file is Gastroenterology Registered Nurse (163WG0100X), and the practice location is in Boise, ID. The record was last updated on May 20, 2020.