Individual
CLINTON L. DILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
176 FALLS AVENUE, TWIN FALLS, ID 83301
(208) 733-3181
(208) 733-3168
Mailing address
176 FALLS AVENUE., TWIN FALLS, ID 83301
(208) 733-3181
(208) 733-3168
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
M7113
ID
207L00000X
Anesthesiology Physician
Primary
M7113
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
804043400
—
ID
Enumeration date
09/26/2006
Last updated
12/11/2017
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