Individual
MARTIN A MANGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
98 N CAMBRIDGE DR, RIGBY, ID 83442-5298
(208) 520-2809
(208) 225-4249
Mailing address
98 N CAMBRIDGE DR, RIGBY, ID 83442-5298
(208) 220-1057
(208) 225-4249
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
O-0518
ID
207Q00000X
Family Medicine Physician
Primary
O-0518
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MR 0934
STATE LICENSE
ID
Enumeration date
06/25/2007
Last updated
04/28/2026
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