Individual
REED IVOL WARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3425 POTOMAC WAY, IDAHO FALLS, ID 83404-4970
(208) 528-8170
(208) 552-5461
Mailing address
3425 POTOMAC WAY, IDAHO FALLS, ID 83404-4970
(208) 528-8170
(208) 552-5461
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0263
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010138476
BS
ID
05
—
806385700
—
ID
01
—
S3812
BC
ID
Enumeration date
11/02/2006
Last updated
09/15/2015
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