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Contact Information

TY B ERICKSON, MD
808 PANCHERI DRIVE
IDAHO FALLS, ID83402-3344
 Phone: 208-552-6900
 Fax: 208-552-4973
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Obstetrics & Gynecology

207V00000X 16 Physician/Obstetrics & Gynecology
 

Urogynecology and Reconstructive Pelvic Surgery

207VF0040X 16 Physician/Obstetrics & Gynecology
Indicates primary specialty

NPI Profile & details for TY B ERICKSON · (Male)

NPI # 1083783823
Status Active
Credentials MD
Entity Individual
Enumeration date 11/07/2006
Last updated 09/09/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • ID License # M-6628
  • ID License # M6628
  • UT License # 6388670-1205
  • ID Medicaid 003678800
Hospital affiliation(s)
  • MOUNTAIN VIEW HOSPITAL - (Acute Care)
    2325 CORONADO STREET
    IDAHO FALLS, ID 83404
  • WILLIAM BEE RIRIE HOSPITAL - (Critical Access)
    1500 AVENUE H
    ELY, NV 89301
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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