Individual
BEN H. GODFREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
450 W STATE ST, SUITE 100, BOISE, ID 83702-6056
(208) 939-1035
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
M-7759
ID
Other
Enumeration date
05/05/2006
Last updated
09/15/2012
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