Stoddard Medical, INC

NPI #1972745594 in Chubbuck, Idaho

Provider Information

NPI Number: 1972745594
Entity Type: Organization
Organization Name: Stoddard Medical, INC
Primary Specialty: Dermatology
Enumeration Date: Mar 27, 2009
Last Updated: Apr 4, 2012

Practice Location

Address: 147 W CHUBBUCK RD
City: Chubbuck
State: Idaho
ZIP Code: 83202-2314
Phone: (208) 238-7546

Authorized Official

Name: EARL R STODDARD, M.D.
Title: OWNER/PHYSICIAN
Phone: (208) 238-7546

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology	207N00000X	Primary

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