Healthcare Provider Details

I. General information

NPI: 1598707226
Provider Name (Legal Business Name): BRYON D HEMPHILL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 NE 10TH AVE
PAYETTE ID
83661-5420
US

IV. Provider business mailing address

1441 NE 10TH AVE
PAYETTE ID
83661-5420
US

V. Phone/Fax

Practice location:
  • Phone: 208-642-9376
  • Fax: 208-642-9598
Mailing address:
  • Phone: 208-642-9376
  • Fax: 208-642-9598

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO171781
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0-244
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: