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General NPI Number Information
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NPI Number | 1447581574
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Entity Type | Organization
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Legal Business Name | DONALD P. WORKMAN, MD PA
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Dates
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Enumeration Date | 01/29/2010
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Last Update Date | 01/29/2010
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Provider Practice Location Address
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Address Line | 496 SHOUP AVE W SUITE D
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City | TWIN FALLS
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State | ID
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Zip | 83301-5043
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Country | US
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Telephone | 208-734-1614
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Fax |
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Provider Business Mailing Address
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Address Line | 496 SHOUP AVE W SUITE D
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City | TWIN FALLS
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State | ID
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Zip | 83301-5043
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Country | US
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Telephone | 208-734-1614
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DONALD P WORKMAN
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Credential | M.D.
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Telephone | 208-734-1614
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | M-5166
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License Number State | ID
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