Individual
DR. JERROLD NEIL FLYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
90 HOPE DR, BUILDING 6000, MOUNTAIN HOME AFB, ID 83648-1057
(208) 828-7600
Mailing address
4476 TUCK ST, MOUNTAIN HOME AFB, ID 83648-1107
(623) 326-8092
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
162603-1
NY
Other
Enumeration date
10/06/2005
Last updated
07/08/2007
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