MEDICARE: DR. ALMA KIMBERLY LEAIRD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RR0500X	Rheumatology Physician	35492	TN
2	207RR0500X	Rheumatology Physician	MC-1637	ID

General Provider Information

NPI Number	:	1154408219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALMA KIMBERLY LEAIRD MD

Provider Business Mailing Address
First Line	:	190 E BANNOCK ST
Second Line	:
City	:	BOISE
State	:	ID
Zip	:	83712-6241
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	520 S EAGLE RD STE 3211
Second Line	:
City	:	MERIDIAN
State	:	ID
Zip	:	83642-6356
Country	:	US
Telephone Number	:	208-706-5930
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	10/10/2022

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