Individual
DR. GREGORY JOHN KADLEC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 FALLS AVE, SUITE 2, TWIN FALLS, ID 83301-3366
(208) 734-6091
(208) 734-4654
Mailing address
800 FALLS AVE, SUITE 2, TWIN FALLS, ID 83301-3366
(208) 734-6091
(208) 734-4654
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
7424
NV
207KA0200X
Allergy Physician
Primary
M2893
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002736200
—
ID
05
—
002736201
—
ID
05
—
002736202
—
ID
Enumeration date
09/20/2005
Last updated
11/01/2011
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