Bryan, Thornton E

Bryan, Thornton E is an individual health care provider with primary practice located at 701 E Parkcenter Blvd , Boise ID 83706-6528. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bryan, Thornton E can be contacted via phone (208) 381-6500.

Contact Information

Primary practice address
701 E Parkcenter Blvd Boise ID 83706-6528
Phone: (208) 381-6500
Fax: (208) 381-6505
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD0000027731 Tennessee
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD.204465 Louisiana
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X M12455 Idaho

Profile Details

NPI number 1003808924
LBN Legal business name Bryan, Thornton E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 17th, 2005
Last updated Sep 26th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003808924 NPPES
Tennessee MEDICAID 3804377
Tennessee MEDICAID 05829798
Tennessee Other 003038788
Tennessee MEDICAID 2158082

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