Individual
JASON DALLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3300 WASHINGTON PKWY, IDAHO FALLS, ID 83404-7592
(208) 522-6662
Mailing address
3300 WASHINGTON PKWY, IDAHO FALLS, ID 83404-7592
(208) 522-6662
Taxonomy
Speciality
Code
Description
License number
State
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
M11813
ID
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
M11813
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1356785018
—
ID
Enumeration date
05/02/2007
Last updated
05/07/2019
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