Dr. Thornton E Bryan III
Family Doctor
701 E Parkcenter Blvd
Boise
, Idaho 83706-6528
Dr. Thornton E Bryan III
Family Doctor
701 E Parkcenter Blvd
Boise
, Idaho 83706-6528
(615) 597-5075
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About
Features
Specialties
- Family Doctor
Languages spoken
- English
Location
First Address
- Dr. Thornton E Bryan III
- 190 E Bannock St
- Boise, ID
- Zip : 83712-6241
- Fax : (615) 597-5075
- Phone : (208) 381-2222
Second Address
- Dr. Thornton E Bryan III
- 701 E Parkcenter Blvd
- Boise, ID
- Zip : 83706-6528
- Fax : (208) 381-6505
- Phone : (208) 381-6500
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Is Dr. Thornton E Bryan III a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207Q00000X | Family Doctor | M12455 | ID |
| N | 207Q00000X | Family Doctor | MD.204465 | LA |
| N | 207Q00000X | Family Doctor | MD0000027731 | TN |
National Provider Identifier
| NPI | 1003808924 |
|---|---|
| Provider Name | Dr. Thornton E Bryan III |
| First Address | Boise, ID 83712-6241 |
| Second Address | Boise, ID 83706-6528 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 17/08/2005 |
| Last Update Date | 26/09/2014 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 003038788 | BCBS OF TN (01) | TN |
| 05829798 | (05) | MS |
| 2158082 | (05) | LA |
| 3804377 | (05) | TN |
| B58919 | (02) | TN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.