# WILLIAM EDER MD

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PSC RADIATE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235472895
- **Authorized official:** MRS. KATIE DAVENPORT (BILLING)
- **Authorized official phone:** (208) 520-2636

## Contact information

- **Practice address:** 3040 E 17TH ST STE A, AMMON, ID 83406-6760
- **Practice address phone:** (208) 557-0998
- **Mailing address:** 3040 E 17TH ST STE A, AMMON, ID 83406-6760
- **Mailing address phone:** (208) 557-0998

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | M3801 | ID | Yes |

## Other

- **Enumeration date:** 04/02/2013
- **Last updated:** 04/02/2013