Individual
BRIAN CARRIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
326 POPLAR ST, BLACKFOOT, ID 83221-1741
(208) 785-5801
(208) 785-3504
Mailing address
98 POPLAR ST, BLACKFOOT, ID 83221-1758
(208) 785-5801
(208) 785-3504
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M-5414
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010002534
REGENCE BLUE SHIELD
ID
05
—
003646800
—
ID
01
—
266529
ALTIUS OLD
ID
01
—
313146
ALTIUS
ID
01
—
74161
BLUE CROSS OLD
ID
01
—
76963
BLUE CROSS
ID
Enumeration date
05/09/2006
Last updated
07/30/2008
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