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Individual

DAVID L. BUDGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
507 S MAIN ST, HAILEY, ID 83333-8929
(208) 542-9111
(208) 542-9114
Mailing address
740 S WOODRUFF AVE, IDAHO FALLS, ID 83401-5285
(208) 542-9111
(208) 542-9114

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
330483-1206
UT
363A00000X
Physician Assistant
Primary
PA-1611
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PA-1611
STATE
ID
Enumeration date
10/13/2006
Last updated
06/16/2020
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