Individual
DR. JOHN KENNETH DUDEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 W FORT ST, MEDICAL SERVICES, BOISE, ID 83702-4501
(208) 422-1325
(208) 422-1319
Mailing address
500 W FORT ST, MEDICAL SERVICES, BOISE, ID 83702-4501
(208) 422-1325
(208) 422-1319
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
21562
AZ
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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