Search › Idaho › 207Q00000X
Bruce Gollub, M.D
NPI 1508855917 · on the registry since 2005
Practice
- Address
- 775 Pole Line Rd W Ste 103
Twin Falls, ID 83301 - Phone
- (208) 814-8375
- Fax
- (208) 814-8376
- Organisation at this address
- St Luke'S Clinic Llc
St Luke'S Clinic, Llc
David Johnson, M.D., P. A.
Arthritis Center Of Idaho,Pa
Bruce C Mccomas, M. D., P. A.Inferred from a shared address, not stated in the registry. - Clinicians at this address
- 108
Additional practice sites
- 401 Botulph Ln, Santa Fe, NM
- 660 2nd Ave. S. Apt A, Ketchum, ID
Registry record
- Primary taxonomy
- 207Q00000X
207Q00000X
- Also registered as
- 207Q00000X
208D00000X - Licence states on file
- NM, ID
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2023-11-30
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