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Individual

DR. BRANDON A. WEST

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1133 CALL PL STE A, POCATELLO, ID 83201-3076
(208) 232-1000
(208) 232-1006
Mailing address
PO BOX 4868, POCATELLO, ID 83205-4868
(208) 236-1600
(208) 236-6695

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
O287
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
806053800
ID
01
S5817
BLUE CROSS
ID
Enumeration date
08/30/2006
Last updated
06/21/2021
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