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Individual

LOIS ADRIAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1450 AVIATION DR, SUITE 100, HAILEY, ID 83333-8785
(208) 788-3434
(208) 788-2025
Mailing address
PO BOX 587, TWIN FALLS, ID 83303-0587
(208) 814-7400
(208) 814-7491

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M4330
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000520200
ID
01
080147002
RR MEDICARE
ID
Enumeration date
06/10/2006
Last updated
09/04/2012
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