Individual
RICHARD K THURSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
229 S 7TH STREET, ST MARIES, ID 83861
(208) 245-5551
Mailing address
PO BOX 411, ST MARIES, ID 83861
(208) 245-2769
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
M-5955
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010004196
REGENCE BS IDAHO
ID
01
—
59550
BC IDAHO
ID
Enumeration date
12/04/2006
Last updated
07/08/2007
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