Spicer, Cory

Spicer, Cory is an sole proprietor health care provider with primary practice located at 2265 E Sunnyside Rd , Idaho Falls ID 83404-7598. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Spicer, Cory can be contacted via phone (208) 542-5000.

Contact Information

Primary practice address
2265 E Sunnyside Rd Idaho Falls ID 83404-7598
Phone: (208) 542-5000
Fax: (208) 542-5151
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X R74548 Arizona
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X R74548 Arizona
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X MED-PHYS-LIC-80820 Montana
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 12620A Wyoming
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X M-15070 Idaho

Profile Details

NPI number 1932512811
LBN Legal business name Spicer, Cory
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 9th, 2014
Last updated May 6th, 2020 - about 5 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 1932512811 NPPES
Idaho MEDICAID 1932512811

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