Individual
BRAD C ERIKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2375 E. SUNNYSIDE RD, STE J, IDAHO FALLS, ID 83404
(208) 542-7060
(208) 522-2202
Mailing address
BRAD C ERIKSON FAMILY PRACTICE, 2375 E. SUNNYSIDE RD, STE J, IDAHO FALLS, ID 83404
(208) 542-7060
(208) 522-2202
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
O-270
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806190400
—
ID
Enumeration date
05/23/2006
Last updated
05/29/2018
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