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Organization

CARTER & RICHARDS, P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. STEPHEN J CARTER M.D. (OWNER PHYSICIAN)
(208) 529-5909
Entity
Organization

Contact information

Practice address
2001 S WOODRUFF AVE, SUITE 3, IDAHO FALLS, ID 83404-6374
(208) 529-5909
(208) 529-5990
Mailing address
2001 S WOODRUFF AVE, SUITE 3, IDAHO FALLS, ID 83404-6374
(208) 529-5909
(208) 529-5990

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
M4157
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010006486
BLUE SHIELD
ID
01
84640
BLUE CROSS
ID
Enumeration date
01/17/2007
Last updated
08/22/2020
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