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MADISON EAR NOSE AND THROAT CLINIC NPI 1265458400


NPI Information

NPI: 1265458400
Provider Name: MADISON EAR NOSE AND THROAT CLINIC
Classification: Otolaryngology - 207Y00000X
Entity Type: Organization
Address:
30 MADISON PROFESSIONAL PARK
REXBURG, ID
ZIP 83440
Phone: (208) 656-9646
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MADISON EAR NOSE AND THROAT CLINIC is an otolaryngology in Rexburg, ID. The provider is an otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. MADISON EAR NOSE AND THROAT CLINIC NPI is 1265458400. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

30 MADISON PROFESSIONAL PARK
REXBURG, ID
ZIP 83440-058
Phone: (208) 656-9646
Fax: (208) 656-9645

The provider's authorized official is Debbie Sue Bulstrode .
The authorized official title is Office Manager and has the following contact phone number (208) 656-9646.

The enumeration date for this NPI number is 7/14/2006 and was last updated on 1/17/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Y00000XOtolaryngology40IDAHOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1=========OTHERIDAHOTAX ID
21369674MEDICARE PINIDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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