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Individual

DR. ERIC W. PERTTULA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2001 S WOODRUFF AVE, SUITE 5, IDAHO FALLS, ID 83404-6374
(208) 528-8777
(208) 528-9777
Mailing address
2001 S WOODRUFF AVE, SUITE 5, IDAHO FALLS, ID 83404-6374
(208) 528-8777
(208) 528-9777

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M8241
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
806018000
ID
Enumeration date
08/10/2005
Last updated
07/11/2016
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