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General NPI Number Information
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NPI Number | 1225359474
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Entity Type | Individual
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Provider Name | TOBY L ANDERTON M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/22/2010
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Last Update Date | 09/17/2019
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Provider Practice Location Address
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Address Line | 2167 VILLAGE PARK AVE SUITE 200
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City | TWIN FALLS
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State | ID
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Zip | 83301
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Country | US
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Telephone | 208-735-3728
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Fax | 208-735-3729
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Provider Business Mailing Address
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Address Line | 2167 VILLAGE PARK AVE SUITE 200
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City | TWIN FALLS
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State | ID
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Zip | 83301
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Country | US
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Telephone | 208-735-3728
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Fax | 208-735-3729
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | M14513
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License Number State | ID
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