Healthcare Provider Details

I. General information

NPI: 1255624441
Provider Name (Legal Business Name): JEDEDIAH HUNTER MAY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2011
Last Update Date: 06/21/2024
Certification Date: 06/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

738 N COLLEGE RD STE B
TWIN FALLS ID
83301-3386
US

IV. Provider business mailing address

738 N COLLEGE RD STE B
TWIN FALLS ID
83301-3386
US

V. Phone/Fax

Practice location:
  • Phone: 208-735-3600
  • Fax: 208-735-3601
Mailing address:
  • Phone: 208-735-3600
  • Fax: 208-735-3601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberM-14318
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberM-14318
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: