Individual
WESLEY DAVID PIDCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4400 E FLAMINGO AVE STE 200, NAMPA, ID 83687
(208) 302-2100
(208) 302-2125
Mailing address
3340 E GOLDSTONE DR, MERIDIAN, ID 83642
(208) 302-2100
(208) 302-2125
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
20A15369
CA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
O-1353
ID
207RP1001X
Pulmonary Disease Physician
DO198185
OR
207RP1001X
Pulmonary Disease Physician
Primary
O-1353
ID
Other
Enumeration date
04/05/2014
Last updated
11/25/2020
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