Individual
CHAD GLEN SIBBETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
777 HOSPITAL WAY, POCATELLO, ID 83201-5175
(208) 239-1000
Mailing address
3816 N HADERLIE LN, IONA, ID 83427-7748
(208) 227-3864
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8671645
ID
Other
Enumeration date
02/14/2025
Last updated
03/05/2025
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