Southard, Andrew Garry
Southard, Andrew Garry is an individual health care provider with primary practice located at 2963 E Copper Point Dr Suite 150, Meridian ID 83642-9055. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Southard, Andrew Garry can be contacted via phone (208) 322-1730.Contact Information
Primary practice address
2963 E Copper Point Dr Suite 150
Meridian ID 83642-9055
Phone: (208) 322-1730
Fax: (208) 322-1731
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | M-11238 | Idaho |
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | RS20070377 | New Mexico |
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | MD183581 | Oregon |
Profile Details
| NPI number | 1154527547 |
|---|---|
| LBN Legal business name | Southard, Andrew Garry |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 22nd, 2007 |
| Last updated | Sep 12th, 2017 - about 7 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 | 1154527547 | NPPES |
| Idaho | Other | M-11238 | LICENSE |
| Idaho | Other | RS20070377 | LICENSE |
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