Individual
DR. CLINT WILL ALLRED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9850 W ST LUKES DR STE 180, NAMPA, ID 83687-7912
(208) 322-1680
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35120055
OH
207RC0000X
Cardiovascular Disease Physician
Primary
8972456-1205
UT
207UN0901X
Nuclear Cardiology Physician
8972456-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
OH
Enumeration date
03/26/2010
Last updated
07/01/2022
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