Organization
ROGER H. TALL M.D. P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROGER H TALL M.D. (PRESIDENT)
(208) 529-0633
Entity
Organization
Contact information
Practice address
2001 S WOODRUFF, SUITE 8, IDAHO FALLS, ID 83404
(208) 529-0633
(208) 529-1948
Mailing address
2001 S WOODRUFF, SUITE 8, IDAHO FALLS, ID 83404
(208) 529-0633
(208) 529-1948
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
M4222
ID
Other
Enumeration date
01/21/2010
Last updated
03/19/2010
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