Tall, Roger H

Tall, Roger H is an sole proprietor health care provider with primary practice located at 2001 S Woodruff Suite 8, Idaho Falls ID 83404. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Tall, Roger H can be contacted via phone (208) 529-0633.

Contact Information

Primary practice address
2001 S Woodruff Suite 8 Idaho Falls ID 83404
Phone: (208) 529-0633
Fax: (208) 529-1948
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X M4222 Idaho

Profile Details

NPI number 1972604494
LBN Legal business name Tall, Roger H
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 26th, 2006
Last updated Dec 22nd, 2010 - about 14 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 1972604494 NPPES
Idaho Other 1912238544 GROUP NPI
Idaho MEDICAID 1972604494 GROUP NPI

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