Individual
DR. JODIE L. DONOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
300 E JEFFERSON ST, SUITE 300, BOISE, ID 83712-6246
(208) 381-4100
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M 12673
ID
Other
Enumeration date
05/04/2011
Last updated
09/14/2015
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