Organization
CALDWELL RADIOLOGICAL ASSOCIATES PROFESSIONAL ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORELI SMITH M.D. (PRESIDENT)
(208) 455-3730
Entity
Organization
Contact information
Practice address
1717 ARLINGTON AVE, CALDWELL, ID 83605-4802
(208) 455-3730
Mailing address
PO BOX 9649, BOISE, ID 83707-4649
(207) 472-8108
(208) 344-1926
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002396000
—
ID
Enumeration date
06/21/2006
Last updated
02/12/2009
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