Idaho Oral Surgery Pllc in Fruitland - Exclusive Provider Organization
Idaho Oral Surgery Pllc - NPI 1912172958
Idaho Oral Surgery Pllc is a Exclusive Provider Organization in Fruitland, Idaho. Idaho Oral Surgery Pllc practices all healthcare services and medical treatments related to Exclusive Provider Organization. The NPI Number for Idaho Oral Surgery Pllc is 1912172958. The last update date is 2010-04-19.
Idaho Oral Surgery Pllc's current location address is 1820 N Whitley Dr, Fruitland, Idaho. You can contact this provider via phone number 2084524808 and fax number 2084526617. The mailing address for Idaho Oral Surgery Pllc is 1820 N Whitley Dr, Fruitland, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Idaho Oral Surgery Pllc |
|---|---|
| Address | 1820 N Whitley Dr, Fruitland, Idaho |
| Phone Number | 2084524808 |
| Fax Number | 2084526617 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | SURGEON |
|---|---|
| Authorized Official Name | Hillam David Ryan |
| Credentials | DDS |
| Telephone Number | 2084524808 |
NPI Number Detail
| NPI Number | 1912172958 |
|---|---|
| Provider Enumeration Date | 2008-04-29 |
| Last Updated Date | 2010-04-19 |
Provider Mailing Address Detail
| Address | 1820 N Whitley Dr |
|---|---|
| City | Fruitland |
| State | Idaho (ID) |
| Post Code | 836192163 |
| Phone Number | 2084524808 |
| Fax Number | 2084526617 |
Provider's Primary Taxonomy Detail
| Speciality | Exclusive Provider Organization |
|---|---|
| Taxonomy | 302F00000X |
| Licence No | D3949OS |
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Definition: (1) An EPO is a form of PPO, in which patients must visit a caregiver that is specified on its panel of providers (is a participating provider). If a visit to an outside(not participating) provider is made the EPO offers very limited or no coverage f |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 241342 | OR | -- | |
| 807651700 | ID | -- |
Post Comment/ Review Below
What is the unique identification code assigned to Idaho Oral Surgery Pllc by the Centers for Medicare & Medicaid Services?
The Idaho Oral Surgery Pllc has been issued the NPI (National Provider Identifier) 1912172958. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where Idaho Oral Surgery Pllc is geographically located?
The Idaho Oral Surgery Pllc is physically situated at the following location: 1820 N Whitley Dr, Fruitland, ID, 836192163.
What is Idaho Oral Surgery Pllc's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Idaho Oral Surgery Pllc is Exclusive Provider Organization, and the corresponding taxonomy classification code for this specialized field is 302F00000X.
On what date did the Idaho Oral Surgery Pllc receive its 1912172958 assignment from the Centers for Medicare & Medicaid Services?
The Idaho Oral Surgery Pllc was assigned its 1912172958 by the Centers for Medicare & Medicaid Services on 2008-04-29.
When was the information regarding Idaho Oral Surgery Pllc, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Idaho Oral Surgery Pllc, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2010-04-19.
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