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Individual

DR. JOHN BRADLEY GOFORTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1072 N LIBERTY STREET, STE 100, BOISE, ID 83704-8706
(208) 302-1200
Mailing address
1072 N LIBERTY ST STE 100, BOISE, ID 83704-8708
(208) 302-1200

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
O-1517
ID

Other

Enumeration date
04/20/2017
Last updated
06/16/2021
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