Individual
DR. JOHN KODATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1510 12TH AVE RD STE 200, NAMPA, ID 83686-6946
(208) 302-6800
(208) 302-6855
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 302-9342
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
R6281
KY
207Q00000X
Family Medicine Physician
Primary
2171959
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/29/2022
Last updated
09/18/2025
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