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Organization
C SCOTT NEEDHAM MD PLLC
Active
Organization
C SCOTT NEEDHAM MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES SCOTT NEEDHAM MD (OWNER)
(406) 690-2008
Entity
Organization
Contact information
Practice address
2805 VALENCIA DR, IDAHO FALLS, ID 83404-7597
(208) 525-9400
Mailing address
2805 VALENCIA DR, IDAHO FALLS, ID 83404-7597
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
NULL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Enumeration date
11/02/2020
Last updated
11/02/2020
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