John W Obray, M.D.
Individual provider Active NPI General Practice Physician · Soda Springs, ID
NPI 1396862033 · NPPES record last updated Sep 11, 2025
Key facts
- NPI
- 1396862033
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- M3806 (ID)
- Practice address
- 296 S 3Rd W
Soda Springs, ID 83276-1561 - Phone
- (208) 547-2779
- Fax
- (208) 547-4910
- NPI assigned
- Mar 26, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M3806 | ID | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alpine Management and Consulting | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | M3806 | ID | |
| General Practice Physician | 208D00000X | M3806 | ID | Yes |
Addresses
Primary practice location
296 S 3Rd W
Soda Springs, ID 83276-1561
Mailing address
296 S 3Rd W
Soda Springs, ID 83276-1561
Phone (208) 547-2779
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000010005790 | Other | ID | REGENCE BLUE SHIELD IDAHO |
| 38067 | Other | ID | BLUE CROSS OF IDAHO |
Other providers in Soda Springs, ID
- Vickie Lozier
- Niki Mix
- Mountain View Dental Clinic
- My Hearing Centers, LLC
- Network for Independence, LLC
- Oregon Trail Eye Care, PC
- PHG Inc.
- PT Works Inc
- Craig Harden Richardson
- RMC Management, LLC
All providers in Soda Springs, ID · General Practice Physician in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.