Individual
DR. JUSTIN MORONI DAZLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
738 N COLLEGE RD, SUITE A, TWIN FALLS, ID 83301-3385
(208) 814-7000
(208) 734-7294
Mailing address
PO BOX 587, TWIN FALLS, ID 83303-0587
(208) 814-7400
(208) 814-7491
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
M11685
ID
207XS0117X
Orthopaedic Surgery of the Spine Physician
M-11685
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851531289
—
ID
Enumeration date
02/25/2009
Last updated
06/03/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us