Provider Demographics
NPI:1407035371
Name:HELMS, JARED ROBERT (DO)
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:ROBERT
Last Name:HELMS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2550 ADDISON AVE E
Mailing Address - Street 2:SUITE E
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-6749
Mailing Address - Country:US
Mailing Address - Phone:208-814-7780
Mailing Address - Fax:208-814-7746
Practice Address - Street 1:2550 ADDISON AVE E
Practice Address - Street 2:SUITE E
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-6749
Practice Address - Country:US
Practice Address - Phone:208-814-7780
Practice Address - Fax:208-814-7746
Is Sole Proprietor?:No
Enumeration Date:2007-10-29
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IDO0557207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID808577100Medicaid
IDP00863516OtherMCRR
PAOS014238OtherLICENSE
ID808577100Medicaid