Individual
JOHN ADAM JELINEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
320 WARNER DR, LEWISTON, ID 83501-4441
(208) 743-3523
(208) 746-8741
Mailing address
320 WARNER DR, LEWISTON, ID 83501-4441
(208) 743-3523
(208) 746-8741
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
M-10275
ID
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
MD 60001068
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
238312
WA DEPT OF LABOR & INDUSTRIES
WA
01
—
77378
BLUE CROSS OF ID
ID
05
—
808097200
—
ID
05
—
8517518
—
WA
Enumeration date
05/05/2006
Last updated
06/24/2016
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