Individual
MR. JOEL THOMAS WEBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
47 N 1ST E, PRESTON, ID 83263
(208) 852-2900
(208) 852-3511
Mailing address
44 N 1ST E, PRESTON, ID 83263-1326
(208) 852-3662
(208) 852-1295
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-766
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184872632
—
ID
01
—
PA-766
PHYSICIAN ASSISTANT LICENSE
ID
Enumeration date
09/08/2008
Last updated
07/05/2018
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