Organization
EAST IDAHO ORTHOPAEDICS, PLLC
Active
Organization
EAST IDAHO ORTHOPAEDICS, PLLC
Active
Other names
Liljenquist & Redd Orthopedic Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH R LILJENQUIST MD (PRESIDENT)
(208) 522-3355
Entity
Organization
Contact information
Practice address
2210 CORONADO ST, IDAHO FALLS, ID 83404-7430
(208) 522-3355
(208) 522-6019
Mailing address
2210 CORONADO ST, IDAHO FALLS, ID 83404-7430
(208) 522-3355
(208) 522-6019
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
M-10197
ID
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
M9781
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807709400
—
ID
Enumeration date
08/22/2007
Last updated
11/12/2025
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