Gundersen, Jason Bill

Gundersen, Jason Bill is an individual health care provider with primary practice located at 3450 Potomac Way , Idaho Falls ID 83404-4970. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Gundersen, Jason Bill can be contacted via phone (208) 557-2900.

Contact Information

Primary practice address
3450 Potomac Way Idaho Falls ID 83404-4970
Phone: (208) 557-2900
Fax: (208) 557-2910
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X M-12486 Idaho

Profile Details

NPI number 1841501731
LBN Legal business name Gundersen, Jason Bill
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 25th, 2010
Last updated Apr 13th, 2015 - about 9 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 1841501731 NPPES
Idaho MEDICAID 1841501731

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