Individual
ALAN D OLMSTEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
844 WASHINGTON ST N STE 100, TWIN FALLS, ID 83301
(208) 734-6800
(208) 735-1635
Mailing address
844 WASHINGTON ST N STE 100, TWIN FALLS, ID 83301-3874
(208) 734-6800
(208) 735-1635
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
M-4775
ID
207N00000X
Dermatology Physician
Primary
M4775
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001242700
—
ID
Enumeration date
10/13/2006
Last updated
12/05/2018
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