Organization · Type 2 NPI

Tony C Roisum MD PA

Family Medicine Physician · Idaho Falls, ID

NPI number 1124115944 Active · reactivated Dec 9, 2008

Practice location

3360 Washington Pkwy, Suite 1
Idaho Falls, ID 83404-8333

Call (208) 524-3416 Map

Fax (208) 524-3138

Mailing address

3360 Washington Pkwy Ste 1
Idaho Falls, ID 83404-7592

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician Primary	207Q00000X	M7389 (ID)
Sports Medicine (Family Medicine) Physician	207QS0010X	M7389 (ID)

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

2 other providers at this address

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About NPI 1124115944

Tony C Roisum MD PA's National Provider Identifier is 1124115944, issued on Oct 5, 2006. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Idaho Falls, ID. The record was last updated on Jan 16, 2026.