Individual
DR. BRAD LEON HYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2550 ADDISON AVE E, SUITE F, TWIN FALLS, ID 83301-6749
(208) 814-7700
(208) 933-9301
Mailing address
PO BOX 587, TWIN FALLS, ID 83303-0587
(208) 814-7400
(208) 814-7491
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
O0628
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1932420783
—
ID
Enumeration date
06/16/2010
Last updated
12/29/2014
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