Individual
DR. GLENN D ZAUSMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
775 POLE LINE RD W, SUITE 301, TWIN FALLS, ID 83301-5814
(208) 814-8700
(208) 933-4914
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 367-5170
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
5101012942
MI
208800000X
Urology Physician
Primary
DO154497
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891767745
—
ID
Enumeration date
02/05/2006
Last updated
12/09/2014
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