Provider Demographics
NPI:1699710541
Name:VERSKA, JOSEPH M (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:M
Last Name:VERSKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8756 W. EMERALD ST.
Mailing Address - Street 2:SUITE 176
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-4834
Mailing Address - Country:US
Mailing Address - Phone:208-378-7700
Mailing Address - Fax:208-378-7701
Practice Address - Street 1:8756 W. EMERALD ST.
Practice Address - Street 2:SUITE 176
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-4834
Practice Address - Country:US
Practice Address - Phone:208-378-7700
Practice Address - Fax:208-378-7701
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM-6730207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID2754500Medicaid
ID002754500Medicaid
IDG06844Medicare UPIN
ID2754500Medicaid
IDP00159625Medicare PIN