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General NPI Number Information
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NPI Number | 1679512982
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Entity Type | Individual
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Provider Name | THOMAS H. RAND MD
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Gender | Male
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Dates
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Enumeration Date | 06/05/2006
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Last Update Date | 09/15/2012
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Provider Practice Location Address
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Address Line | 100 E IDAHO ST SUITE 200
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City | BOISE
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State | ID
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Zip | 83712-6267
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Country | US
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Telephone | 208-381-7330
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Fax | 208-381-7331
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Provider Business Mailing Address
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Address Line | 190 E BANNOCK ST
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City | BOISE
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State | ID
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Zip | 83712-6241
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Country | US
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Telephone | 208-381-7330
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Fax | 208-381-7331
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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 | 2080P0208X
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Taxonomy Name | Pediatric Infectious Diseases Physician
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License Number | M6109
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License Number State | ID
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