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Dr. Brandon D Wilde, DPM
Foot & Ankle Surgery Podiatrist in Pocatello, Idaho
NPI 1407169865

Brandon D Wilde is a Foot & Ankle Surgery Podiatrist based in Pocatello, ID and is specialized in Foot & Ankle Surgery. Brandon D Wilde practices in Pocatello, ID and has the professional credentials of DPM. The NPI Number for Brandon D Wilde is 1407169865 and holds a License No. P-217 (Idaho).

The current practice location address for Brandon D Wilde is 1455 Bench Rd Ste B, Pocatello, ID and can be reached out via phone at 208-232-0006 and via fax at 208-233-8771. You can also correspond with Brandon D Wilde through the mailing address at 1455 BENCH RD, POCATELLO, ID - 83201-5083 (mailing address contact number: 208-232-0006).

Location: 1455 Bench Rd Ste B, Pocatello, ID, 83201-5083
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Provider Profile Details
NPI Number
1407169865
Provider Name
Brandon D Wilde
Credential
DPM
Provider Entity Type
Individual
Gender
Male
Address
1455 Bench Rd Ste B, Pocatello, ID, 83201-5083
Phone Number
208-232-0006
Fax Number
208-233-8771
Provider Enumeration Date
07/14/2010
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1407169865 05 MO
P01271994 01 MO RAILROAD MEDICARE
institution
Provider Business Practice Location Address Details
Address
1455 Bench Rd Ste B
City
State
Zip
83201-5084
Phone Number
208-232-0006
Fax Number
208-233-8771
person
Provider Business Mailing Address Details
Address
1455 Bench Rd Ste B
City
State
Zip
83201-5084
Phone Number
208-232-0006
Fax Number
208-233-8771
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
License No.
P-217 (Idaho)
Definition
Definition to come...
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