Wray, Adam

Wray, Adam is an individual health care provider with primary practice located at 326 Poplar St , Blackfoot ID 83221-1741. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Wray, Adam can be contacted via phone (208) 785-5801.

Contact Information

Primary practice address
326 Poplar St Blackfoot ID 83221-1741
Phone: (208) 785-5801
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X O-0444 Idaho

Profile Details

NPI number 1902952930
LBN Legal business name Wray, Adam
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 25th, 2007
Last updated Apr 17th, 2008 - about 18 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1902952930 NPPES
Idaho Other S6117 BLUE CROSS POC
Idaho Other 000010163015 BLUE CROSS POC
Idaho Other 000010163016 BLUE CROSS POC
Idaho Other 315520 BLUE CROSS POC
Idaho Other S6116 BLUE CROSS POC

Popular Providers