Individual
DR. BRIGHAM B REDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2210 CORONADO ST, IDAHO FALLS, ID 83404
(208) 522-3355
(208) 522-6019
Mailing address
2210 CORONADO ST, IDAHO FALLS, ID 83404
(208) 522-3355
(208) 522-6019
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
01054412A
IN
207X00000X
Orthopaedic Surgery Physician
Primary
M-10197
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1144208059
—
MT
05
—
1902841893
—
WY
05
—
808106500
—
ID
Enumeration date
01/03/2006
Last updated
09/01/2021
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