Individual
MR. JOHN D WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
777 N RAYMOND ST, BOISE, ID 83704-9251
(208) 514-2500
(208) 375-2217
Mailing address
777 N RAYMOND ST, BOISE, ID 83704-9251
(208) 514-2500
(208) 375-2217
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
11095
MT
207Q00000X
Family Medicine Physician
Primary
M-13395
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0158950
—
MT
05
—
1235122714
—
ID
Enumeration date
08/30/2005
Last updated
09/23/2016
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