Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | M8547 | ID |
Y | 2086S0105X | Surgery of the Hand | M8547 | ID |
NPI | 1457345316 |
---|---|
Provider Name | Vermon S Esplin |
First Address | Pocatello, ID 83201-2745 |
Second Address | Pocatello, ID 83201-2745 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2005 |
Last Update Date | 29/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
20003825 | (02) | ID |
G88862 | (02) | ID |