Individual
JOHN R PEARCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1825 S KIMBALL AVE, CALDWELL, ID 83605-4828
(208) 455-3545
(208) 454-9690
Mailing address
1825 S KIMBALL AVE, CALDWELL, ID 83605-4828
(208) 455-3545
(208) 454-9690
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
O283
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806342000
—
ID
Enumeration date
06/15/2006
Last updated
01/23/2008
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