# ENNIS ENDOCRINOLOGY, PLLC

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

## Provider details

- **NPI number:** 1902143134
- **Authorized official:** DR. ROBERT FRANK ENNIS M.D. (PHYSICIAN)
- **Authorized official phone:** (208) 994-8180

## Contact information

- **Practice address:** 2450 E GALA ST STE 100, MERIDIAN, ID 83642-4805
- **Practice address phone:** (208) 994-8180
- **Practice address fax:** (208) 908-4542
- **Mailing address:** 2498 W TIMBER DR, EAGLE, ID 83616-4665
- **Mailing address phone:** (208) 994-8180

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | M-11309 | ID | Yes |

## Other

- **Enumeration date:** 01/08/2013
- **Last updated:** 04/09/2020