Isaiah Austin, O.D.
Individual provider Active NPI Optometrist · Twin Falls, ID
NPI 1760504237 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1760504237
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- ODP100082 (ID)
- Practice address
- 731 Poleline Rd
Twin Falls, ID 83301-3036 - Phone
- (208) 732-5688
- Fax
- (208) 736-1596
- NPI assigned
- Apr 4, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ODP100082 | ID | MD | Optometrist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | ODP100082 | ID | Yes |
Addresses
Primary practice location
731 Poleline Rd
Twin Falls, ID 83301-3036
Mailing address
217 Buchanan St
Twin Falls, ID 83301-5242
Phone (208) 948-5551
Other providers in Twin Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.