NPI 1972745594

Stoddard Medical, INC

Organisation Dermatology Physician Chubbuck, ID

Practice location

Address: 147 W Chubbuck Rd, Chubbuck, ID 83202-2314
Phone: (208) 238-7546
Fax: (208) 237-9643

Authorised official

Name: Earl R Stoddard
Title: Owner/Physician
Phone: (208) 238-7546

Registered specialties

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X Licence M9280 (ID)

Other Dermatology providers in Idaho →

Registry record

NPI: 1972745594
Entity type: Organization
NPI issued: 27 Mar 2009
Record last updated: 4 Apr 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.