Individual
LANDON KELLY GRANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5680 W GAGE ST, BOISE, ID 83706
(208) 773-3937
(208) 377-3937
Mailing address
3867 MIRAMAR ST, APARTMENT G, LA JOLLA, CA 92037-1312
(208) 559-6893
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
M14219
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043620255
—
ID
Enumeration date
04/28/2014
Last updated
07/26/2018
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us