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Individual

PEGGY TORO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
315 W IDAHO ST, BLACKFOOT, ID 83221-1711
(208) 782-3990
(208) 782-3994
Mailing address
98 POPLAR ST, BLACKFOOT, ID 83221-1758
(208) 782-3990
(208) 782-3994

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M-8772
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010149456
REGENCE BLUE SHIELD
ID
01
268231
ALTIUS OLD
ID
01
313068
ALTIUS
ID
01
73924
BLUE CROSS OLD
ID
01
76962
BLUE CROSS
ID
05
806699000
ID
Enumeration date
05/03/2006
Last updated
04/30/2008
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