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General NPI Number Information
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NPI Number | 1346155421
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Entity Type | Organization
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Legal Business Name | A DYNAMICS OF IDAHO PC
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Dates
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Enumeration Date | 08/14/2026
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Last Update Date | 08/14/2026
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Provider Practice Location Address
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Address Line | 875 S VANGUARD WAY STE 120
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City | MERIDIAN
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State | ID
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Zip | 83642-8541
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Country | US
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Telephone | 888-851-4642
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Fax |
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Provider Business Mailing Address
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Address Line | 1846 1ST ST STE 100 NUM 380811
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City | IDAHO FALLS
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State | ID
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Zip | 83401
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Country | US
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Telephone | 888-851-4642
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Fax |
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Authorized Official
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Title or Position | EXEC VP OF OPERATIONS
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Name | LAURA ADKINS
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Credential |
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Telephone | 828-424-0869
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State | NULL
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