Organization
IDAHO PAIN CENTER AND ANESTHESIA PC
Active
Other names
RAYMOND L. BEDELL, DO
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNA BEDELL (ACCOUNTS MANAGER)
(435) 755-0964
Entity
Organization
Contact information
Practice address
286 N GATEWAY DR, PROVIDENCE, UT 84332-9733
(435) 755-9184
(435) 755-9148
Mailing address
286 N GATEWAY DR, STE 201, PROVIDENCE, UT 84332-5602
(435) 755-9174
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
329116-1204
UT
208VP0014X
Interventional Pain Medicine Physician
329116-1204
UT
Other
Enumeration date
10/17/2007
Last updated
07/18/2013
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