Sandison, Richard A

Sandison, Richard A is an individual health care provider with primary practice located at 775 Pole Line Rd W Suite 105, Twin Falls ID 83301-5814. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Sandison, Richard A can be contacted via phone (208) 814-8000.

Contact Information

Primary practice address
775 Pole Line Rd W Suite 105 Twin Falls ID 83301-5814
Phone: (208) 814-8000
Fax: (208) 733-9402
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X M6273 Idaho

Profile Details

NPI number 1649216961
LBN Legal business name Sandison, Richard A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2006
Last updated Jan 2nd, 2015 - about 10 years 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 1649216961 NPPES
Idaho MEDICAID 003949400
Idaho Other P00460908

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