Individual
LAURA M FALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
801 POLE LINE RD W, SUITE 3880, TWIN FALLS, ID 83301-5810
(208) 814-8500
(208) 814-8596
Mailing address
PO BOX 587, TWIN FALLS, ID 83303-0587
(208) 814-7400
(208) 814-7491
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M6080
ID
207V00000X
Obstetrics & Gynecology Physician
M6080
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000209800
—
ID
Enumeration date
04/27/2006
Last updated
04/24/2020
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