Doctor Name: | DAVID L DAY |
NPI Number: | 1649321134 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | P.A. |
License Number: | PA394 |
Business Practice Address: | 32 W 1st S Rexburg, ID - 834401810 |
Business Phone Number: | 2083567585 |
Business Fax Number: | 2083567566 |
Mailing Address: | 15 Jerry Ln, REXBURG |
State: | ID |
Postal Code: | 834403586 |
Phone Number: | 2083590621 |
Fax Number: | |
NPI Enumeration Date: | 01/13/2007 |
NPI Last Update Date: | 09/07/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | PA394 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |