Individual
DR. CARL DAVID VANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3910 WASHINGTON PARKWAY, IDAHO FALLS, ID 83404-7596
(208) 523-1122
(208) 523-2582
Mailing address
3910 WASHINGTON PARKWAY, IDAHO FALLS, ID 83404-7596
(208) 523-1122
(208) 523-2582
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
M7763
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110187174
RAILROAD MEDICARE
ID
01
—
120165400
WYOMING CONSULTEC EDS
ID
01
—
25853
BLUESHIELD OF IDAHO
ID
01
—
32035
DMBA
ID
01
—
804012300
HEALTHY CONNECTIONS
ID
05
—
805400000
—
ID
01
—
DZ643
BLUECROSS OF IDAHO
ID
Enumeration date
07/30/2005
Last updated
10/15/2021
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