Tony C Roisum Md Pa in Idaho Falls - Sports Medicine
Tony C Roisum Md Pa - NPI 1124115944
Tony C Roisum Md Pa is a Sports Medicine in Idaho Falls, Idaho. Tony C Roisum Md Pa practices all healthcare services and medical treatments related to Sports Medicine. The NPI Number for Tony C Roisum Md Pa is 1124115944. The last update date is 2016-05-20.
Tony C Roisum Md Pa's current location address is 3360 Washington Pkwy, Idaho Falls, Idaho. You can contact this provider via phone number 2085243416 and fax number 2085243138. The mailing address for Tony C Roisum Md Pa is 3360 Washington Pkwy, Idaho Falls, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Tony C Roisum Md Pa |
|---|---|
| Address | 3360 Washington Pkwy, Idaho Falls, Idaho |
| Phone Number | 2085243416 |
| Fax Number | 2085243138 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER / PR |
|---|---|
| Authorized Official Name | Roisum C Tony |
| Credentials | MD |
| Telephone Number | 2085243416 |
NPI Number Detail
| NPI Number | 1124115944 |
|---|---|
| Provider Enumeration Date | 2006-10-05 |
| Last Updated Date | 2016-05-20 |
Provider Mailing Address Detail
| Address | 3360 Washington Pkwy |
|---|---|
| City | Idaho Falls |
| State | Idaho (ID) |
| Post Code | 834048333 |
| Phone Number | 2085243416 |
| Fax Number | 2085243138 |
Provider's Primary Taxonomy Detail
| Speciality | Sports Medicine |
|---|---|
| Taxonomy | 207Qs0010X |
| Licence No | M7389 |
|
Definition: A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 10004286 | ID | BLUE SHIELD | |
| B5824 | BLUE CROSS | ||
| DJ475 | ID | BLUE CROSS | |
| 119166700 | WY | -- | |
| 185461600 | ID | US DEPT OF LABOR | |
| 502862456001 | UT | -- | |
| 23397 | BLUE SHIELD | ||
| 805076700 | ID | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Tony C Roisum Md Pa by the Centers for Medicare & Medicaid Services?
The Tony C Roisum Md Pa has been assigned the NPI (National Provider Identifier) 1124115944. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete physical address where Tony C Roisum Md Pa is located?
The Tony C Roisum Md Pa is situated at the following address: 3360 Washington Pkwy, Idaho Falls, ID, 834048333.
What is the Tony C Roisum Md Pa's specialty and taxonomy code?
The Tony C Roisum Md Pa's specialty is Sports Medicine, and the corresponding taxonomy code is 207Qs0010X.
On what date did Tony C Roisum Md Pa receive its 1124115944 assignment from the Centers for Medicare & Medicaid Services?
The Tony C Roisum Md Pa was assigned its 1124115944 on 2006-10-05, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the information regarding Tony C Roisum Md Pa most recently updated?
The details pertaining to the Tony C Roisum Md Pa, including its address, specialty, and other relevant information, were last refreshed on 2016-05-20.