Detar, Thomas R

Detar, Thomas R is an individual health care provider with primary practice located at 849 N Syringa St , Post Falls ID 83854-8794. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Otolaryngology. Allopathic & Osteopathic Physicians / Otolaryngology is his primary health care specialty. Detar, Thomas R can be contacted via phone (208) 777-1320.

Contact Information

Primary practice address
849 N Syringa St Post Falls ID 83854-8794
Phone: (208) 777-1320
Fax: (208) 777-1322
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X M-7110 Idaho
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X M-7110 Idaho

Profile Details

NPI number 1548265028
LBN Legal business name Detar, Thomas R
Credentials M.D., F.A.C.S.
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2005
Last updated Feb 6th, 2024 - about 10 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548265028 NPPES
Idaho MEDICAID 002802400

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