Konrad, Donald J
Konrad, Donald J is an sole proprietor health care provider with primary practice located at 1224 8Th St , Rupert ID 83350-1527. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Konrad, Donald J can be contacted via phone (208) 436-5266.Contact Information
Primary practice address
1224 8Th St
Rupert ID 83350-1527
Phone: (208) 436-5266
Fax: (208) 434-8675
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | O154 | Idaho |
Profile Details
| NPI number | 1306836077 |
|---|---|
| LBN Legal business name | Konrad, Donald J |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 25th, 2005 |
| Last updated | Jan 6th, 2012 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306836077 | NPPES |
| Idaho | Other | S1543 | BLUE CROSS |
| Idaho | MEDICAID | M0014062 | BLUE CROSS |
| Idaho | Other | 10001772 | BLUE CROSS |
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