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Organization
INLAND NORTHWEST FOOT AND ANKLE PC
Active
Organization
INLAND NORTHWEST FOOT AND ANKLE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN T THOMPSON DPM (OWNER)
(208) 777-9794
Entity
Organization
Contact information
Practice address
1590 E POLSTON AVE, STE A, POST FALLS, ID 83854-5218
(208) 777-9794
(208) 777-9523
Mailing address
1590 E POLSTON AVE, STE A, POST FALLS, ID 83854-5218
(208) 777-9794
(208) 777-9523
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
P173
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010149213
BLUE SHIELD
ID
01
—
I0007985456
AETNA
ID
01
—
P00224830
RR MEDICARE PIN
ID
01
—
P2165
BLUE CROSS - PROVIDER #
ID
01
—
P9293
BLUE CROSS - CLINIC #
ID
Enumeration date
12/09/2005
Last updated
01/18/2008
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