Individual
JOHN JOSEPH KIEHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1072 N LIBERTY ST, SUITE 203, BOISE, ID 83704-8708
(208) 302-5800
(208) 302-5855
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 302-5800
(208) 302-5855
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
6027170-1205
UT
208000000X
Pediatrics Physician
Primary
M-9876
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807844700
—
ID
Enumeration date
02/16/2007
Last updated
11/10/2016
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