Individual
JUDY LEE JONES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2001 S WOODRUFF, SUITE 19, IDAHO FALLS, ID 83404
(208) 529-2603
(208) 529-0451
Mailing address
2001 S WOODRUFF, SUITE 19, IDAHO FALLS, ID 83404
(208) 529-2603
(208) 529-0451
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M4671
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010005844
REGENCE BLUE SHIELD
ID
05
—
000384000
—
ID
01
—
46714
BLUE CROSS
ID
Enumeration date
02/06/2006
Last updated
02/18/2010
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