Individual
BRENT BLUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
190 MUSTANG DRIVE, DRIGGS, ID 83422-0000
(307) 733-7835
(307) 201-4999
Mailing address
PO BOX 25, WILSON, WY 83014-0025
(307) 733-7835
(307) 201-4999
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
A31472
CA
207Q00000X
Family Medicine Physician
Primary
3416A
WY
261QU0200X
Urgent Care Clinic/Center
3416A
WY
Other
Enumeration date
05/23/2006
Last updated
03/06/2026
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