Organization
MIRANDA MEDICAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. A RICHARD MIRANDA M.D. (CEO)
(208) 420-1319
Entity
Organization
Contact information
Practice address
706 N COLLEGE RD, SUITE A, TWIN FALLS, ID 83301-5824
(208) 736-8006
(208) 329-7159
Mailing address
PO BOX 5498, TWIN FALLS, ID 83303-5498
(208) 736-8006
(208) 329-7159
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
M-9799
ID
207RH0003X
Hematology & Oncology Physician
MD151354
OR
Other
Enumeration date
04/20/2016
Last updated
04/20/2016
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