Individual
RICHARD A WATHNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2240 E CENTER ST, POCATELLO, ID 83201-2600
(208) 233-2100
(208) 233-3146
Mailing address
2240 E CENTER ST, POCATELLO, ID 83201-2600
(208) 233-2100
(208) 233-3146
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
M6663
ID
Other
Enumeration date
11/01/2006
Last updated
09/07/2021
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