Individual
LANCE SPENCER LONGMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1515 E CLARK ST, POCATELLO, ID 83201-4133
(208) 233-2273
(208) 417-0272
Mailing address
1515 E CLARK ST, POCATELLO, ID 83201-4133
(208) 233-2273
(208) 417-0272
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
O-0711
ID
207RC0000X
Cardiovascular Disease Physician
O-0711
ID
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
O-0711
ID
207UN0901X
Nuclear Cardiology Physician
O-0711
ID
Other
Enumeration date
08/01/2006
Last updated
06/10/2021
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