DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. RICKY DWAYNE LATHAM, MD

Active

Cardiovascular Disease · IDAHO FALLS, ID

Registration Details

NPI Number
1477553139
Provider Type
Individual
Gender
Male
NPI Issued
Jul 26, 2005 (20.799233730863 yrs)
Last Updated
Feb 13, 2019
Licenses
M6887 (ID)
MD170342 (OR)

Practice Information

Address
2001 VALENICA DRIVE
SUITE 201
IDAHO FALLS, ID, 83404
Browse ID providers · Browse ZIP 83404
Phone
2085249400
Fax
2085249401
Primary Specialty
Cardiovascular Disease
207RC0000X
Additional Specialty
Cardiovascular Disease

Other Cardiovascular Disease Providers in IDAHO FALLS, ID

Name Credential NPI
MR. DOUGLAS U. BLANK MD 1871598631
MR. JOHN D CHAMBERS JR. M.D. 1578568242
GEORGE M GARCIA MD 1548266315
DR. PATRICK D GORMAN MD 1295735769
PAUL A GERLACH MD 1215025648
DR. SCOTT KERMIT HUFFAKER D.O 1346462306
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.