Individual
DR. JOSEPH GORDON DAINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
766 W COLCHESTER DR, EAGLE, ID 83616-5888
(208) 401-4790
Mailing address
766 W COLCHESTER DR, EAGLE, ID 83616-5888
(208) 401-4790
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
M3286
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010003325
REGENCE BLUE SHIELD
ID
05
—
003653900
—
ID
01
—
32862
BLUE CROSS
ID
01
—
P00185340
TRAVELERS MEDICARE
ID
Enumeration date
05/09/2006
Last updated
10/27/2010
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