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Organization

GREGORY M. FORD, MD PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GREGORY M FORD MD (OWNER)
(208) 478-4522
Entity
Organization

Contact information

Practice address
950 HOSPITAL WAY, STE A, POCATELLO, ID 83201-2789
(208) 478-4522
(208) 712-6868
Mailing address
950 HOSPITAL WAY, STE A, POCATELLO, ID 83201-2789
(208) 478-4522
(208) 712-6868

Taxonomy

Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
M-12085
ID

Other

Enumeration date
06/02/2014
Last updated
07/21/2022
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