Individual
JUDSON ROBERT MEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
520 S EAGLE RD, MERIDIAN, ID 83642-6351
(208) 381-6930
(208) 381-6931
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-8752
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
ES60317745
WA
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
06/14/2022
Last updated
11/10/2022
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