Individual
RICHARD AVERY HEARN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
201 E CENTER ST, POCATELLO, ID 83201-6339
(208) 232-6101
Mailing address
201 E CENTER ST, POCATELLO, ID 83201-6339
(208) 232-6101
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M-7189
ID
Other
Enumeration date
09/09/2011
Last updated
09/09/2011
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