Individual
DR. BRAD Q STARLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
775 POLE LINE RD W, SUITE 203, TWIN FALLS, ID 83301-5814
(208) 814-8300
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101239001
VA
207RG0100X
Gastroenterology Physician
12112
ND
207RG0100X
Gastroenterology Physician
Primary
M-12760
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669443909
—
ID
Enumeration date
01/26/2006
Last updated
07/09/2015
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