Organization
IDAHO EMERGENCY PHYSICIANS, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON WILIDING M.D. (CHAIRMAN AND PRESIDENT)
(208) 322-1730
Entity
Organization
Contact information
Practice address
2963 E COPPER POINT DR, SUITE 150, MERIDIAN, ID 83642-9055
(208) 322-1730
(208) 322-1731
Mailing address
PO BOX 5666, DENVER, CO 80217-5666
(208) 322-1730
(208) 322-1731
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002426500
—
ID
Enumeration date
05/20/2006
Last updated
09/25/2015
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