Individual
JOHN L SHUSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
775 POLE LINE RD W, SUITE 216, TWIN FALLS, ID 83301-5814
(208) 814-8450
(208) 814-8934
Mailing address
PO BOX 587, TWIN FALLS, ID 83303-0587
(208) 814-8450
(208) 814-8934
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
M4944
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003957500
—
ID
01
—
P00712962
MCRR
ID
Enumeration date
06/15/2006
Last updated
01/02/2015
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