Individual
DR. RICHARD WILLIS RUNYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
150 VISTA DR, POCATELLO, ID 83201-5824
(208) 232-7246
Mailing address
3385 POTOMAC WAY, IDAHO FALLS, ID 83404-4978
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
9169428-8905
UT
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
M-14202
ID
Other
Enumeration date
04/04/2013
Last updated
10/25/2023
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