Pond, Tyler Jordan
Pond, Tyler Jordan is an individual health care provider with primary practice located at 150 N Woodruff Ave , Idaho Falls ID 83401-4335. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Pond, Tyler Jordan can be contacted via phone (208) 557-3255.Contact Information
Primary practice address
150 N Woodruff Ave
Idaho Falls ID 83401-4335
Phone: (208) 557-3255
Fax: (208) 471-5069
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA-1590 | Idaho |
Profile Details
| NPI number | 1356844500 |
|---|---|
| LBN Legal business name | Pond, Tyler Jordan |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 14th, 2018 |
| Last updated | Dec 23rd, 2025 - about last year |
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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