Individual
JOSEPH PENDLETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1450 AVIATION DR STE 100, HAILEY, ID 83333-8785
(208) 788-3434
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M-15465
ID
Other
Enumeration date
05/01/2019
Last updated
05/23/2024
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