TONY CRAIG ROISUM


Address: 3360 Washington Pkwy, Suite 1, Idaho Falls, ID 83404-8332
Phone: 2085243416

TONY CRAIG ROISUM (NPI# 1770688426) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1770688426
Entity Type Individual
Full Name TONY CRAIG ROISUM
Credential M.D.
Practice Address 3360 Washington Pkwy
Suite 1
Idaho Falls
ID 83404-8332
Practice Telephone 2085243416
Practice Fax Number 2085243138
Mailing Telephone 2085243416
Mailing Fax Number 2085243138
Enumeration Date 2006-09-14
Last Update Date 2010-04-28
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207Q00000X Family Medicine M7389 ID Allopathic & Osteopathic Physicians
N 2083S0010X Preventive Medicine
Specialization: Sports Medicine
M7389 ID Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
ID US DEPT OF LABOR 185461600 01
ID BLUE CROSS DJ475 01
ID IRS INDIVIDUAL TAXPAYER # 820496957 01
WY 119166700 05
ID 805076700 05
ID REGENCE BLUE SHIELD 000010004286 01

Office Location

Street Address 3360 WASHINGTON PKWY
SUITE 1
City IDAHO FALLS
State ID
Zip Code 83404-8332

Providers in the same location

NPI Name Taxonomy Address Enumeration
1821370461 Alan Joel Jensen Physician Assistant 3360 Washington Pkwy, Suite 2, Idaho Falls, ID 83404-8332 2011-09-09
1124115944 Tony C Roisum Md Pa Family Medicine 3360 Washington Pkwy, Suite 1, Idaho Falls, ID 83404-8333 2006-10-05

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1437750809 Joshua M Murphy Dentist 1580 Elk Creek Dr., Idaho Falls, ID 83404 2020-11-03
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1942863600 Muhammad Arslan Khan Student in an Organized Health Care Education/Training Program 2860 Channing Way Suite 214, Idaho Falls, ID 83404 2019-04-18
1942771043 Physician's Choice Cardiology, Pllc Internal Medicine 3302 Valencia, Suite 201, Idaho Falls, ID 83404 2018-12-16
1609358761 Cardiac Cath Lab of Idaho Falls Internal Medicine 3311 Valencia Drive, Idaho Falls, ID 83404 2018-09-05
1083196380 Hannah Golden Occupational Therapist 1460 Elk Creek, Idaho Falls, ID 83404 2018-09-04
1316423049 Lindsay Sessions Speech-Language Pathologist 2210 Niagara St, Idaho Falls, ID 83404 2018-07-16
1720574023 Bmh, Inc. Anesthesiology 3302 Valencia Dr., Suite 201, Idaho Falls, ID 83404 2018-07-10
1093237935 Jason Earl Bailey Contractor 3100 S Woodruff Ave., Idaho Falls, ID 83404 2017-07-12
1235682121 Mountain Falls Quick Care Clinic/Center 1995 E 17th St #1, Idaho Falls, ID 83404 2016-07-27
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Taxonomy Information

Taxonomy Code 207Q00000X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine

Taxonomy Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition]
- Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences.
- Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1740663806 Rindfleisch Family Practice Pllc Family Medicine 4954 E Powerhouse Dr, Idaho Falls, ID 83406-5064 2015-07-07
1013204445 Machen Family Medicine, PC Family Medicine 1995 E 17th St Ste A, Idaho Falls, ID 83404-6493 2011-07-06
1942521109 Luke N/a Haws Family Medicine 2985 Cortez Ave Ste 200, Idaho Falls, ID 83404-7554 2010-06-22
1689993271 David Lyle Hill Family Medicine 3242 S Woodruff, Idaho Falls, ID 83404-7531 2010-05-23
1912120544 James William Brook Family Medicine 905 Austin Ave, Idaho Falls, ID 83404 2007-04-11
1437294345 Oliver Daniel Smith Family Medicine 3669 Ellendale Circle, Idaho Falls, ID 83406 2007-02-20
1023151156 Physician Skin Care Family Medicine 730 S Woodruff Ave, Idaho Falls, ID 83401-5285 2007-02-15
1598837031 Anne L Broadway Family Medicine 2730 Channing Way, Idaho Falls, ID 83404-5049 2006-11-13
1235217506 Reed Ivol Ward Family Medicine 3425 Potomac Way, Idaho Falls, ID 83404-4970 2006-11-02
1356450449 Roger S. Brunt Family Medicine 2340 Virlow St, Idaho Falls, ID 83401-3323 2006-08-30
Find all providers in IDAHO FALLS

Competitor

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City IDAHO FALLS
Zip Code 83404

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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