GLEN S LOVELACE MD PA
NPI 1023053204
Specialist in Boise, ID

Q: What is Glen S Lovelace MD PA's NPI number?

The NPI number for Glen S Lovelace MD PA is 1023053204. It was assigned to this organization in the NPPES registry on June 19, 2006.

Q: What is Glen S Lovelace MD PA's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Active since June 19, 2006

333 N 1ST ST STE 260, BOISE, ID 83702(208) 345-3136(208) 345-0984 Get Directions Write a Review

NPPES record last updated: June 1, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Glen S Lovelace Md Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GLEN S LOVELACE MD PA (NPI 1023053204) is a healthcare organization registered as a specialist in Boise, Idaho and active in the NPI registry since June 2006. The organization lists Glen S Lovelace, Owner, as its authorized official.

NPPES Registry Identity

NPI1023053204

Entity TypeOrganization

Primary Taxonomy174400000X

Legal Business NameGLEN S LOVELACE MD PA

Location Address333 N 1ST ST STE 260Boise, ID 83702-6132

Mailing Address333 N 1st St Ste 260Boise, ID 83702-6132 · (208) 345-3136 · Fax (208) 345-0984

Phone(208) 345-3136

Fax(208) 345-0984

Organization SubpartNo

Authorized OfficialGlen S LovelaceOwner · (208) 345-3136

Enumeration DateJune 19, 2006

Last NPPES UpdateJune 1, 2009

✔ NPI 1023053204 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

License✔ Licensed in ID · M6570

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

333 N 1ST ST STE 260, Boise, ID 83702

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Other Identifiers 3

Other000010028711ID · Blue Shield Group Number

Other8D608ID · Blue Cross Group Number

Medicare ID-Type Unspecified1377264ID · Group Number

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..Insurance ›

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. MEGAN ASHLEY KITTERMAN CNM

Advanced Practice Midwife