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Contact Information

BRYAN VANDYKE, DO
2321 CORONADO ST
IDAHO FALLS, ID83404-7407
 Phone: 208-227-1100
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Foot and Ankle Surgery

207XX0004X 02 Physician/General Surgery
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for BRYAN VANDYKE · (Male)

NPI Number 1285990374
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 04/03/2012
Last updated 01/23/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • ID License # O-1166
Hospital affiliation(s)
  • EASTERN IDAHO REGIONAL MEDICAL CENTER - (Acute Care)
    3100 CHANNING WAY
    IDAHO FALLS, ID 83404
  • MOUNTAIN VIEW HOSPITAL - (Acute Care)
    2325 CORONADO STREET
    IDAHO FALLS, ID 83404
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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