Individual
DR. ANDREW GARRY SOUTHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2963 E COPPER POINT DR, SUITE 150, MERIDIAN, ID 83642-9055
(208) 322-1730
(208) 322-1731
Mailing address
2963 E COPPER POINT DR, SUITE 150, MERIDIAN, ID 83642-9055
(208) 322-1730
(208) 322-1731
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
M-11238
ID
207P00000X
Emergency Medicine Physician
Primary
MD183581
OR
207P00000X
Emergency Medicine Physician
RS20070377
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M-11238
LICENSE
ID
01
—
RS20070377
TRAINING
NM
Enumeration date
06/22/2007
Last updated
12/22/2025
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