# DESTIN THAYNE BEP INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790244424
- **Authorized official:** DESTIN L THAYNE (OWNER)
- **Authorized official phone:** (208) 359-2101

## Contact information

- **Practice address:** 859 S YELLOWSTONE HWY STE 3201, REXBURG, ID 83440-6200
- **Practice address phone:** (208) 359-2101
- **Practice address fax:** (208) 356-8860
- **Mailing address:** 859 S YELLOWSTONE HWY STE 3201, REXBURG, ID 83440-6200
- **Mailing address phone:** (208) 359-2101
- **Mailing address fax:** (208) 356-8860

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/12/2019
- **Last updated:** 08/12/2021