Individual
DR. JEFFREY KARL EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
777 N RAYMOND ST, BOISE, ID 83704-9251
(208) 514-2500
(208) 375-2217
Mailing address
777 N RAYMOND ST, BOISE, ID 83704-9251
(208) 514-2500
(208) 375-2217
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M-6059
ID
207Q00000X
Family Medicine Physician
M2312
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578566253
—
ID
05
—
176499501
—
TX
Enumeration date
05/24/2005
Last updated
07/13/2016
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