Organization
REED I. WARD, D.O., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REED IVOL WARD D.O. (OWNER)
(208) 528-8170
Entity
Organization
Contact information
Practice address
3425 POTOMAC WAY, IDAHO FALLS, ID 83404-4984
(208) 528-8170
(208) 522-5461
Mailing address
3360 WASHINGTON PKWY STE 2, IDAHO FALLS, ID 83404-8333
(208) 528-8170
(208) 522-5461
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
O-263
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010138476
REGENCE BLUE SHIELD OF ID
ID
01
—
080184962
RAILROAD MEDICARE
ID
05
—
806385700
—
ID
01
—
8N464
BLUE CROSS OF IDAHO
ID
Enumeration date
07/10/2007
Last updated
02/24/2020
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