Tony Craig Roisum in Idaho Falls - Sports Medicine
Tony Craig Roisum - NPI 1770688426
Tony Craig Roisum is a Sports Medicine in Idaho Falls, Idaho. Tony Craig Roisum practices all healthcare services and medical treatments related to Sports Medicine. The NPI Number for Tony Craig Roisum is 1770688426. The last update date is 2010-04-28.
Tony Craig Roisum'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 Craig Roisum is 3360 Washington Pkwy, Idaho Falls, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Tony Craig Roisum |
|---|---|
| Address | 3360 Washington Pkwy, Idaho Falls, Idaho |
| Phone Number | 2085243416 |
| Fax Number | 2085243138 |
| Sole Proprietor | Y |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1770688426 |
|---|---|
| Provider Enumeration Date | 2006-09-14 |
| Last Updated Date | 2010-04-28 |
Provider Mailing Address Detail
| Address | 3360 Washington Pkwy |
|---|---|
| City | Idaho Falls |
| State | Idaho (ID) |
| Post Code | 834048332 |
| Phone Number | 2085243416 |
| Fax Number | 2085243138 |
Provider's Primary Taxonomy Detail
| Speciality | Sports Medicine |
|---|---|
| Taxonomy | 2083S0010X |
| Licence No | M7389 |
|
Definition: A preventive medicine physician who specializes in the diagnosis and treatment of sports related conditions and injuries. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 10004286 | ID | REGENCE BLUE SHIELD | |
| 119166700 | WY | -- | |
| 820496957 | ID | IRS INDIVIDUAL TAXPAYER # | |
| DJ475 | ID | BLUE CROSS | |
| 805076700 | ID | -- | |
| 185461600 | ID | US DEPT OF LABOR |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Tony Craig Roisum by the Centers for Medicare & Medicaid Services?
The Tony Craig Roisum has been assigned the NPI (National Provider Identifier) 1770688426 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Can you provide the Tony Craig Roisum's physical address?
The Tony Craig Roisum is physically located at 3360 Washington Pkwy, in the city of Idaho Falls, ID, with the postal code 834048332.
What is the Tony Craig Roisum's area of specialization and corresponding taxonomy classification?
The Tony Craig Roisum's specialty field is Sports Medicine, and it falls under the taxonomy code 2083S0010X, which categorizes healthcare providers based on their specialties.
On what date did the Tony Craig Roisum receive its 1770688426 assignment from the Centers for Medicare & Medicaid Services?
The Tony Craig Roisum was assigned its 1770688426 by the Centers for Medicare & Medicaid Services on 2006-09-14.
As of what date were the details pertaining to Tony Craig Roisum last refreshed?
The information related to the Tony Craig Roisum, including its address, specialty, and other relevant details, was last updated on 2010-04-28.