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1164459541
JON PARKER WAGNILD
BOISE, ID
NPI
1164459541
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207RN0300X Internal Medicine, Nephrology
(Licence: ID M4213)
Enumeration Date
2006-06-28
Last Update Date
2007-07-08
Business Address
Dr. JON PARKER WAGNILD MD
5610 GAGE ST SUITE A
BOISE, ID 83706-1349
Phone number: 208-367-3370
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Mailing Address
Dr. JON PARKER WAGNILD MD
984 W BOGUS VIEW CT
EAGLE, ID 83616-5878
Phone number:
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