Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | M-5532 | ID |
N | 111NI0900X | Internist | M-5532 | ID |
Y | 2080A0000X | Adolescent Medicine | M-5532 | ID |
NPI | 1114929122 |
---|---|
Provider Name | Dr. Don E Mcinturff |
First Address | Pocatello, ID 83201-5091 |
Second Address | Pocatello, ID 83201-5091 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2005 |
Last Update Date | 23/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003823100 | (05) | ID |
E04232 | (02) | ID |