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Organization

STODDARD & BINGHAM MEDICAL OF TWIN FALLS PLLC

Active
Other names
Idaho Skin Institute of Twin Falls
Organization subpart
No

Provider details

NPI number
Authorized official
EARL R STODDARD MD (OWNER)
(208) 238-7546
Entity
Organization

Contact information

Practice address
1411 FALLS AVE E STE 1002, TWIN FALLS, ID 83301-3459
(208) 595-5424
(208) 595-5426
Mailing address
147 W CHUBBUCK RD, CHUBBUCK, ID 83202-2314
(208) 238-7546
(208) 237-9643

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1164834073
PERSONAL NPI
01
1528533296
PERSONAL NPI
ID
01
1548482482
PERSONAL NPI
01
1760400238
PERSONAL NPI
ID
Enumeration date
08/05/2021
Last updated
07/25/2023
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