Whalio Doctors

NPI 1124462494

Upper Valley Ent & Allergy PLLC

Organisation Otolaryngology/Facial Plastic Surgery Physician Rexburg, ID

Practice location

Address
256 N 2nd E, Rexburg, ID 83440-1638
Phone
(208) 656-9646
Fax
(208) 656-9645

Authorised official

Name
Jay Robert McMaster
Title
Physician/Surgeon
Phone
(208) 656-9646

Registered specialties (3)

Otolaryngology/Facial Plastic Surgery Physician Primary
Allopathic & Osteopathic Physicians Taxonomy 207YX0905X
Allergy Physician
Allopathic & Osteopathic Physicians Taxonomy 207KA0200X
Medical Physician Assistant
Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363AM0700X

Registry record

NPI
1124462494
Entity type
Organization
NPI issued
17 Apr 2013
Record last updated
11 Jun 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.