DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. JOHN BRADLEY RUDOLPH, D.O.

Active Sole Proprietor

DR. JOHN BRADLEY RUDOLPH, D.O. is a Family Medicine healthcare provider located in LEWISTON, Idaho. NPI 1548503022 is currently active in the NPPES registry. Verify at CMS.

Family Medicine · LEWISTON, ID

Registration Details

NPI Number
1548503022
Provider Type
Individual
Gender
Male
NPI Issued
Apr 3, 2013 (13.356963160353 yrs)
Last Updated
Dec 26, 2024
Licenses
OP60506022 (WA)
O-0990 (ID)
Sole Proprietor
Yes

Practice Information

Address
415 6TH ST STE 3C
LEWISTON, ID, 835012431
Browse ID providers · Browse ZIP 83501
Phone
2087507300
Fax
2087464899
Primary Specialty
Family Medicine
207Q00000X
Additional Specialty
Family Medicine

Other Family Medicine Providers in LEWISTON, ID

Name Credential NPI
DR. CHRISTINE C SCHALLER MD 1063415404
DR. DONALD J GREGGAIN M.D. 1154328052
MR. RAYMOND M. PAZ M.D. 1760475206
LARRY DEAN HARRIES MD 1033105994
RICHARD SCOTT LEON MD 1972562841
DR. MICHAEL J BALDECK D.O. 1669428967
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.