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Organization
IDAHO PAIN CENTER AND ANESTHESIA PC
Active
Organization
IDAHO PAIN CENTER AND ANESTHESIA PC
Active
Other names
RAYMOND L. BEDELL, DO
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNA BEDELL (ACCOUNTS MANAGER)
(435) 755-0964
Entity
Organization
Contact information
Practice address
286 N GATEWAY DR, PROVIDENCE, UT 84332-9733
(435) 755-9184
(435) 755-9148
Mailing address
286 N GATEWAY DR, STE 201, PROVIDENCE, UT 84332-5602
(435) 755-9174
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
329116-1204
UT
208VP0014X
Interventional Pain Medicine Physician
329116-1204
UT
Other
Enumeration date
10/17/2007
Last updated
07/18/2013
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