Organization
SNAKE RIVER UROLOGY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID BOWYER M.D. (PHYSICIAN)
(208) 732-3040
Entity
Organization
Contact information
Practice address
660 SHOSHONE ST E, SUITE 201, TWIN FALLS, ID 83301-6110
(208) 732-3040
(208) 732-3195
Mailing address
660 SHOSHONE ST E, SUITE 201, TWIN FALLS, ID 83301-6110
(208) 732-3040
(208) 732-3195
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
340019783
RR MEDICARE
ID
05
—
805710000
—
ID
Enumeration date
06/01/2006
Last updated
06/17/2008
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