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Individual

DAVID LAXSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
100 HOSPITAL DRIVE, KETCHUM, ID 83340
(208) 727-8710
Mailing address
PO BOX 640, BOISE, ID 83701-0640

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
26977
MN
207RC0000X
Cardiovascular Disease Physician
Primary
M-15593
ID

Other

Enumeration date
12/28/2005
Last updated
01/04/2022
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