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Individual

DR. STANLEY BRANDON GROVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
98 POPLAR ST, BLACKFOOT, ID 83221-1799
(208) 785-4100
Mailing address
98 POPLAR ST, BLACKFOOT, ID 83221-1799
(208) 785-4100

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0102205572
VA
207P00000X
Emergency Medicine Physician
Primary
5771083
ID
207P00000X
Emergency Medicine Physician
DO0000003381
TN
207Q00000X
Family Medicine Physician
0102205572
VA
207Q00000X
Family Medicine Physician
DO0000003381
TN
208D00000X
General Practice Physician
5101021975
MI

Other

Enumeration date
06/25/2015
Last updated
03/26/2026
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