Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
TONY C ROISUM MD PA
Deactivated OrganizationTONY C ROISUM MD PA is a Family Medicine organization located in IDAHO FALLS, Idaho. NPI 1124115944 is deactivated in the NPPES registry. Verify at CMS.
Family Medicine · IDAHO FALLS, ID
This NPI has been deactivated.
The record was deactivated on July 24, 2007.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1124115944
- Provider Type
- Organization
- NPI Issued
- Oct 5, 2006 (0.8 yrs)
- Last Updated
- Jan 16, 2026
- Deactivated
- Jul 24, 2007
- Licenses
-
M7389 (ID)M7389 (ID)
Practice Information
- Address
-
3360 WASHINGTON PKWYSUITE 1IDAHO FALLS, ID, 834048333Browse ID providers · Browse ZIP 83404
- Phone
- 2085243416
- Fax
- 2085243138
- Primary Specialty
-
Family Medicine
207Q00000X
- Additional Specialty
- Family Medicine
Other Family Medicine Organizations in IDAHO FALLS, ID
| Name | NPI |
|---|---|
| WALLACE C BAKER | 1134140148 |
| COMMUNITY CARE PLLC | 1326061565 |
| COMMUNITY CARE | 1790708832 |
| COMMUNITY CARE PLLC | 1205846425 |
| IDAHO URGENT CARE | 1649345661 |
| SOUTHEAST IDAHO FAMILY PRACTICE | 1982759007 |
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.