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Individual

DR. THOMAS ERNEST PRYOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
121 5TH AVE WEST, GOODING, ID 83330
(208) 934-4800
(208) 934-9611
Mailing address
121 5TH AVE WEST, GOODING, ID 83330
(208) 934-4800
(208) 934-9611

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2011020656
MO
207Q00000X
Family Medicine Physician
46233
TN
207Q00000X
Family Medicine Physician
Primary
M7337
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
805049900
ID
Enumeration date
11/06/2006
Last updated
12/15/2011
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