Individual
DR. JONATHAN V. GILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3399 E LOUISE DR, SUITE 400, MERIDIAN, ID 83642-5047
(208) 364-3000
(208) 364-3191
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
M8195
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020049568
RR MEDICARE
—
05
—
8059976W
—
ID
Enumeration date
07/05/2006
Last updated
07/20/2017
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