Tanner Bodily

NPI 1356957039 · on the registry since 2020

Practice

Address: 3360 Washington Pkwy Ste 1
Idaho Falls, ID 83404
Phone: (208) 524-3416
Organisation at this address: Taylor G Wright Pc
Tony C Roisum Md Pa
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 9

Registry record

Primary taxonomy: 363A00000X
363A00000X
Also registered as: 390200000X
Licence states on file: ID
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2026-07-30

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho