Individual
TYLER R WAYMENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
738 N COLLEGE RD, SUITE A, TWIN FALLS, ID 83301-3385
(208) 814-7000
(208) 734-7294
Mailing address
PO BOX 587, TWIN FALLS, ID 83303-0587
(208) 814-7400
(208) 814-7491
Taxonomy
Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
M9557
ID
208200000X
Plastic Surgery Physician
Primary
M9557
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807460000
—
ID
01
—
P00721156
MCRR
ID
Enumeration date
05/15/2006
Last updated
01/02/2015
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