Individual
JEREMY WHITING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2990 CORTEZ AVE, IDAHO FALLS, ID 83404-7554
(208) 535-0440
(208) 535-0550
Mailing address
2990 CORTEZ AVE, IDAHO FALLS, ID 83404-7554
(208) 535-0440
(208) 535-0550
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
M-15245
ID
207V00000X
Obstetrics & Gynecology Physician
MT210943
PA
Other
Enumeration date
06/17/2016
Last updated
12/18/2022
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