Individual
DOUGLAS FAVOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
777 HOSPITAL WAY, EMERGENCY DEPT, POCATELLO, ID 83201
(208) 417-7569
Mailing address
PO BOX 64568, PHOENIX, AZ 85082-4568
(208) 417-7569
(480) 585-0051
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
M6949
ID
Other
Enumeration date
06/19/2006
Last updated
09/05/2019
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