Tony C Roisum Md Pa, NPI 1124115944
Family Medicine Physician in Idaho Falls, ID, US
NPI number: what is it?
The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...
| NPI | 1124115944 |
| NPI Entity Type | Organization |
| Provider Name |
Tony C Roisum Md Pa
Doing Business As |
| Enumeration Date | September 30, 2009 |
| Last Update Date | September 30, 2009 |
| Provider Location Address | 3360 Washington Pkwy, Suite 1, Idaho Falls, ID, US |
| Provider Mailing Address | 3360 Washington Pkwy, Suite 1, Idaho Falls, ID, US, 834048333 |
| Is Sole Proprietor? | No |
Organization Official
| Official Name | MD Tony C Roisum |
| Official Position | OWNER / PRESIDENT |
| Phone | 208-524-3416 |
Group Taxonomy
| Taxonomy Code | 193200000X |
| Taxonomy Name | 193200000X MULTI-SPECIALTY GROUP |
| Definition | A business group of one or more individual practitioners, who practice with different areas of specialization. |
Primary Taxonomy
| Taxonomy Code | |
| Taxonomy Name | Family Medicine Physician |
| Classification | |
| Group | |
| License No. | M7389 |
| License State | ID |
| Description | Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
Secondary Taxonomies
| Taxonomy Code | Group | Classification | License No. | State | Primary? |
|---|---|---|---|---|---|
| M7389 | ID | No |
Other Identifiers
| Identifier | Identifier State | Identifier Issuer | Type/Code |
|---|---|---|---|
| 000010004286 | ID | BLUE SHIELD | 01 |
| B5824 | BLUE CROSS | 01 | |
| DJ475 | ID | BLUE CROSS | 01 |
| 119166700 | WY | MEDICAID | 05 |
| 185461600 | ID | US DEPT OF LABOR | 01 |
| 502862456001 | UT | MEDICAID | 05 |
| 23397 | BLUE SHIELD | 01 | |
| 805076700 | ID | MEDICAID | 05 |
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