MEDICARE: TODD GLEN HASTINGS D.O.

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	2083X0100X	Occupational Medicine Physician	O-1112	ID

General Provider Information

NPI Number	:	1386955060
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TODD GLEN HASTINGS D.O.

Provider Business Mailing Address
First Line	:	2436 BUCKINGHAM CT
Second Line	:
City	:	TWIN FALLS
State	:	ID
Zip	:	83301-4499
Country	:	US
Telephone Number	:	307-438-1428
Fax Number	:

Provider Business Practice Location Address
First Line	:	625 POLE LINE RD W STE 1B
Second Line	:
City	:	TWIN FALLS
State	:	ID
Zip	:	83301-4269
Country	:	US
Telephone Number	:	208-814-8100
Fax Number	:

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

Provider Enumeration Date	:	06/28/2010
Last Update Date	:	03/18/2026

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Directions to “ TODD GLEN HASTINGS D.O.” Practice Location

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