Individual
DR. MILES HUBBARD HUMPHREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
238 MARTIN ST, TWIN FALLS, ID 83301-4542
(208) 734-4670
(208) 734-4990
Mailing address
238 MARTIN ST, TWIN FALLS, ID 83301-4542
(208) 734-4670
(208) 734-4990
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
M3006
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010135113
BLUE SHIELD OF IDAHO
ID
05
—
002581400
—
ID
01
—
DW094
BLUE CROSS OF IDAHO
ID
Enumeration date
06/21/2005
Last updated
05/11/2011
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