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Individual

DR. SCOTT J WEBSTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
530 N 2ND E, REXBURG, ID 83440-3566
(208) 359-2814
(208) 359-1937
Mailing address
530 N 2ND E, REXBURG, ID 83440
(208) 624-3229

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
P5117
ID
183500000X
Pharmacist
Primary
P5903
ID
183500000X
Pharmacist
P5994
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
002142100
ID
Enumeration date
04/17/2007
Last updated
09/02/2008
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