Search › Idaho › 363A00000X
Jed Willardson, PA
NPI 1578716072 · on the registry since 2008
Practice
- Address
- 2377 Coronado St
Suite C
Idaho Falls, ID 83404 - Phone
- (208) 523-7246
- Fax
- (208) 523-7247
- Clinicians at this address
- 9
Registry record
- Primary taxonomy
- 363A00000X
363A00000X
- Licence states on file
- ID
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2009-03-04
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho