MEDICARE: GUY ERIC GROOMS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	20183	OK
2	207X00000X	Orthopaedic Surgery Physician	M-13759	ID

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053316786
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GUY ERIC GROOMS MD

Provider Business Mailing Address
First Line	:	535 W SUNNYSIDE RD STE 2
Second Line	:
City	:	IDAHO FALLS
State	:	ID
Zip	:	83402-4647
Country	:	US
Telephone Number	:	208-357-9700
Fax Number	:	208-963-3245

Provider Business Practice Location Address
First Line	:	535 W SUNNYSIDE RD STE 2
Second Line	:
City	:	IDAHO FALLS
State	:	ID
Zip	:	83402-4647
Country	:	US
Telephone Number	:	208-357-9700
Fax Number	:	208-963-3245

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	06/18/2025

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Directions to “ GUY ERIC GROOMS MD” Practice Location

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