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Organization

UPPER VALLEY ENT & ALLERGY PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JAY ROBERT MCMASTER DO (PHYSICIAN/SURGEON)
(208) 656-9646
Entity
Organization

Contact information

Practice address
256 N 2ND E, REXBURG, ID 83440-1638
(208) 656-9646
(208) 656-9645
Mailing address
256 N 2ND E, REXBURG, ID 83440-1638
(208) 656-9646
(208) 656-9645

Taxonomy

Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
363AM0700X
Medical Physician Assistant

Other

Enumeration date
04/17/2013
Last updated
06/11/2014
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