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Individual

DR. JOHN L CALDERWOOD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
1814 LINCOLN WAY, COEUR D ALENE, ID 83814-2540
(208) 667-2531
(208) 667-7730
Mailing address
1814 LINCOLN WAY, COEUR D ALENE, ID 83814-2540
(208) 667-2531
(208) 667-7730

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
OD00003976
WA
152W00000X
Optometrist
Primary
ODP100067
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010149990
REGENCE BLUE SHIELD OF IDAHO
ID
01
000010149991
REGENCE BLUE SHIELD OF IDAHO
ID
01
000010171389
REGENCE BLUE SHIELD OF IDAHO
ID
01
196382
LABOR & INDUSTRIES
WA
05
2031565
WA
05
2031573
WA
05
807139300
ID
05
807139301
ID
01
8905514
CRIME VICTIMS
WA
01
OMXPR0072446
MOLINA HEALTHCARE
WA
01
V9030
BLUE CROSS OF IDAHO
ID
Enumeration date
10/26/2005
Last updated
08/23/2023
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