Ty Bolton Erickson in Idaho Falls - Female Pelvic Medicine And Reconstructive Surgery
Ty Bolton Erickson - NPI 1083783823
Ty Bolton Erickson is a Female Pelvic Medicine And Reconstructive Surgery in Idaho Falls, Idaho. Ty Bolton Erickson practices all healthcare services and medical treatments related to Female Pelvic Medicine And Reconstructive Surgery. The NPI Number for Ty Bolton Erickson is 1083783823. The last update date is 2014-09-09.
Ty Bolton Erickson's current location address is 2184 Channing Way Pmb #135, Idaho Falls, Idaho. You can contact this provider via phone number 2085526914 and fax number 2085524973. The mailing address for Ty Bolton Erickson is 2184 Channing Way Pmb #135, Idaho Falls, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Ty Bolton Erickson |
|---|---|
| Address | 2184 Channing Way Pmb #135, Idaho Falls, Idaho |
| Phone Number | 2085526914 |
| Fax Number | 2085524973 |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1083783823 |
|---|---|
| Provider Enumeration Date | 2006-11-07 |
| Last Updated Date | 2014-09-09 |
Provider Mailing Address Detail
| Address | 2184 Channing Way Pmb #135 |
|---|---|
| City | Idaho Falls |
| State | Idaho (ID) |
| Post Code | 834048034 |
| Phone Number | 2085526914 |
| Fax Number | 2085524973 |
Provider's Primary Taxonomy Detail
| Speciality | Female Pelvic Medicine And Reconstructive Surgery |
|---|---|
| Taxonomy | 207Vf0040X |
| Licence No | M6628 |
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Definition: A subspecialist in Female Pelvic Medicine and Reconstructive Surgery is a physician in Urology or Obstetrics and Gynecology who, by virtue of education and training, is prepared to provide consultation and comprehensive management of women with compl |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 3678800 | ID | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Ty Bolton Erickson by the Centers for Medicare & Medicaid Services?
The Ty Bolton Erickson has been assigned the NPI (National Provider Identifier) 1083783823. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical location address where Ty Bolton Erickson's facilities are situated?
The facilities of Ty Bolton Erickson are physically located at the following address: 2184 Channing Way Pmb #135, Idaho Falls, ID, 834048034.
What is Ty Bolton Erickson's specialized field of practice, and what is the corresponding taxonomy classification code?
The Ty Bolton Erickson's area of specialization is Female Pelvic Medicine And Reconstructive Surgery, and the corresponding taxonomy code that categorizes this field of practice is 207Vf0040X.
On what date did the Ty Bolton Erickson receive the assignment of its 1083783823 from the Centers for Medicare & Medicaid Services?
The Ty Bolton Erickson was issued its 1083783823 by the Centers for Medicare & Medicaid Services on 2006-11-07.
As of what date was the information pertaining to Ty Bolton Erickson, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Ty Bolton Erickson, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2014-09-09.