Individual
DR. KELLY JAROM ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3430 WASHINGTON PKWY, IDAHO FALLS, ID 83404-7579
(208) 523-3060
(208) 523-0028
Mailing address
3430 WASHINGTON PKWY, IDAHO FALLS, ID 83404-7579
(208) 523-3060
(208) 523-0028
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
M10579
ID
Other
Enumeration date
05/22/2007
Last updated
09/10/2009
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