Basic Information
Provider Information
NPI: 1831467810
EntityType: 2
ReplacementNPI:  
OrganizationName: JAMES T ANNEST MD PC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 1657
Address2:  
City: TWIN FALLS
State: ID
PostalCode: 833031657
CountryCode: US
TelephoneNumber: 2087343356
FaxNumber: 2087339463
Practice Location
Address1: 115 FALLS AVE W
Address2:  
City: TWIN FALLS
State: ID
PostalCode: 833013115
CountryCode: US
TelephoneNumber: 2087343356
FaxNumber: 2087339463
Other Information
ProviderEnumerationDate: 12/06/2011
LastUpdateDate: 12/06/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: ANNEST
AuthorizedOfficialFirstName: JAMES
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: OWNER
AuthorizedOfficialTelephone: 2087343356
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: M.D.
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XM3751IDY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


Home