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Organization

LORRAINE TANGEN M.D. PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LORRAINE TANGEN M.D. (PHYSICIAN)
(208) 324-6656
Entity
Organization

Contact information

Practice address
1100 N LINCOLN AVE, JEROME, ID 83338-1856
(208) 324-6656
Mailing address
1100 N LINCOLN AVE, JEROME, ID 83338-1856
(208) 324-4825

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
M 6344
ID

Other

Enumeration date
06/10/2016
Last updated
06/10/2016
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