Individual
DR. GREGORY EDWIN BIDDULPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3300 WASHINGTON PKWY, IDAHO FALLS, ID 83404-7592
(208) 522-6662
(208) 522-0880
Mailing address
3300 WASHINGTON PKWY, IDAHO FALLS, ID 83404-7592
(208) 522-6662
(208) 522-0880
Taxonomy
Speciality
Code
Description
License number
State
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
M6968
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010000552
BS
ID
01
—
00001000552
MEDIVANTAGE BS
ID
05
—
0027971
—
ID
05
—
113909600
—
WY
01
—
185543500
US DEPARTMENT OF LABOR
KY
01
—
20036025
RAILROAD MEDICARE
TN
05
—
286007
—
OR
01
—
29868
BXI
ID
01
—
613028
BX BS VA
VA
05
—
7608951
—
NC
01
—
8157532
OUT OF STATE MEDICAL
CA
Enumeration date
06/28/2006
Last updated
03/10/2015
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