Gambles, Dallin Brim

Gambles, Dallin Brim is an individual health care provider with primary practice located at 380 Walker Dr , Rexburg ID 83440-1657. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Gambles, Dallin Brim can be contacted via phone (208) 356-9559.

Contact Information

Primary practice address
380 Walker Dr Rexburg ID 83440-1657
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA-236 Idaho

Profile Details

NPI number 1760533400
LBN Legal business name Gambles, Dallin Brim
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 16th, 2007
Last updated Jul 9th, 2007 - about 19 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 1760533400 NPPES
Idaho Other P00134875 RAILROAD MEDICARE
Idaho Other PALDO RAILROAD MEDICARE

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