Individual
DR. JON-ERIC BAILLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8100 W EMERALD ST STE 180, BOISE, ID 83704
(208) 377-3299
(208) 460-5227
Mailing address
8100 W EMERALD ST STE 180, BOISE, ID 83704-9069
(208) 377-3299
(208) 460-5227
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
M7882
ID
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
M7882
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805693500
—
ID
Enumeration date
08/08/2006
Last updated
05/22/2018
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