Organization
BRIAN E O'BYRNE, M.D. P.A.
Active
Parent organization
BRIAN E O'BYRNE, M.D. P.A.
Organization subpart
Yes
Provider details
NPI number
Legal business name
BRIAN E O'BYRNE, M.D. P.A.
Authorized official
BRIAN E O'BYRNE M.D. (OWNER)
(208) 535-4470
Entity
Organization
Contact information
Practice address
2860 CHANNING WAY STE 117, IDAHO FALLS, ID 83404-7532
(208) 535-4470
(208) 535-4476
Mailing address
2860 CHANNING WAY STE 117, IDAHO FALLS, ID 83404-7532
(208) 535-4470
(208) 535-4476
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
M6123
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1770822074
NPPES
ID
01
—
1801896717
NPPES
ID
Enumeration date
11/03/2009
Last updated
03/31/2014
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