Redden, Kaleb
Redden, Kaleb is an individual health care provider with primary practice located at 777 N Raymond St , Boise ID 83704-9251. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Redden, Kaleb can be contacted via phone (208) 514-2500.Contact Information
Primary practice address
777 N Raymond St
Boise ID 83704-9251
Phone: (208) 514-2500
Fax: (208) 375-2217
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Sports Medicine | 207QS0010X | O-0995 | Idaho |
Profile Details
| NPI number | 1366822892 |
|---|---|
| LBN Legal business name | Redden, Kaleb |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 29th, 2015 |
| Last updated | Jun 19th, 2019 - about 6 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 | 1366822892 | NPPES |
| Idaho | MEDICAID | 1366822892 |
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