Edwards, Brad Reid

Edwards, Brad Reid is an individual health care provider with primary practice located at 3430 Washington Pkwy , Idaho Falls ID 83404-7579. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Edwards, Brad Reid can be contacted via phone (208) 523-3060.

Contact Information

Primary practice address
3430 Washington Pkwy Idaho Falls ID 83404-7579
Phone: (208) 523-3060
Fax: (208) 523-0028
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X O316 Idaho

Profile Details

NPI number 1093829657
LBN Legal business name Edwards, Brad Reid
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2006
Last updated Sep 30th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093829657 NPPES
Wyoming MEDICAID 1285786046
Wyoming Other 000010143893
Wyoming MEDICAID 806644500
Wyoming MEDICAID 123957100
Wyoming MEDICAID 0117436
Wyoming Other 54380

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