Individual
DR. JOHN CHARLES KIRKHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
115 W MAIN ST STE 202, BOISE, ID 83702-7303
(208) 433-9466
Mailing address
115 W MAIN ST STE 202, BOISE, ID 83702-7303
(208) 433-9466
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
7245122-1205
UT
2085R0202X
Diagnostic Radiology Physician
Primary
M-10927
ID
Other
Enumeration date
05/17/2007
Last updated
03/23/2010
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