Individual
DR. GREGORY LYNN FLINT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
868 E RIVERSIDE DR, SUITE 200, EAGLE, ID 83616-6019
(208) 367-2864
(208) 323-0310
Mailing address
868 E RIVERSIDE DR, SUITE 200, EAGLE, ID 83616-6019
(208) 367-2864
(208) 323-0310
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
M3500
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010004115
REGENCE BLUESHIELD OF ID
ID
05
—
002486300
—
ID
01
—
070002801
RAILROAD MEDICARE
ID
01
—
35006
BLUE CROSS OF IDAHO
ID
Enumeration date
09/26/2006
Last updated
07/28/2009
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