Individual provider · Type 1 NPI

Lee S. Gardner, P.A.-C

Medical Physician Assistant · Idaho Falls, ID

NPI number 1063589612 Active

Practice location

2725 Channing Way
Idaho Falls, ID 83404-7510

Fax (208) 525-8118

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA-359 (ID)

Medical Physician Assistant: Definition to come...

8 other providers at this address

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About NPI 1063589612

Lee S. Gardner, P.A.-C's National Provider Identifier is 1063589612, issued on Nov 29, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Idaho Falls, ID. The record was last updated on Dec 7, 2009.