Individual provider · Type 1 NPI

Ricky Dwayne Latham, MD

Cardiovascular Disease Physician · Idaho Falls, ID

NPI number 1477553139 Active

Practice location

2001 Valenica Drive, Suite 201
Idaho Falls, ID 83404

Fax (208) 524-9401

Mailing address

1775 Thompson Rd
Coos Bay, OR 97420-2125

Specialties and licenses

TaxonomyCodeLicense
Cardiovascular Disease Physician 207RC0000XM6887 (ID)
Cardiovascular Disease Physician Primary 207RC0000XMD170342 (OR)

Cardiovascular Disease Physician: An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

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About NPI 1477553139

Ricky Dwayne Latham, MD's National Provider Identifier is 1477553139, issued on Jul 26, 2005. The primary taxonomy on file is Cardiovascular Disease Physician (207RC0000X), and the practice location is in Idaho Falls, ID. The record was last updated on Feb 13, 2019.