Individual
MATTHEW P TRAYNOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2100 PROVIDENCE WAY, IDAHO FALLS, ID 83404
(208) 529-6600
(208) 529-6602
Mailing address
2100 PROVIDENCE WAY, IDAHO FALLS, ID 83404-4951
(208) 529-6600
(208) 529-6602
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
24632
OK
207W00000X
Ophthalmology Physician
M-10686
ID
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
Primary
M-10686
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
808405700
—
ID
Enumeration date
01/16/2007
Last updated
02/21/2023
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