Individual
DR. CARL SCOTT HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3381 W BAVARIA STREET, EAGLE, ID 83616-5341
(208) 639-4800
(208) 639-4801
Mailing address
3381 W BAVARIA STREET, EAGLE, ID 83616-5341
(208) 639-4800
(208) 639-4801
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
M9563
ID
Other
Enumeration date
11/08/2005
Last updated
02/06/2012
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