Individual
BRIAN E O'BYRNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2860 CHANNING WAY, STE 117, IDAHO FALLS, ID 83404-7532
(208) 523-2470
(208) 523-1118
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
05
—
000084200
—
ID
Enumeration date
07/21/2005
Last updated
12/22/2010
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