Tony C Roisum MD PA
NPI #1124115944 in Idaho Falls, Idaho
Provider Information
- NPI Number
- 1124115944
- Entity Type
- Organization
- Organization Name
- Tony C Roisum MD PA
- Primary Specialty
- Family Medicine
- Enumeration Date
- Oct 5, 2006
- Last Updated
- Jan 16, 2026
Practice Location
- Address
- 3360 WASHINGTON PKWY
- Address 2
- SUITE 1
- City
- Idaho Falls
- State
- Idaho
- ZIP Code
- 83404-8333
- Phone
- (208) 524-3416
Authorized Official
- Name
- JACQUELINE KELSEY
- Title
- OFFICE MANAGER
- Phone
- (208) 524-3416
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine - Sports Medicine — Sports Medicine |
| Family Medicine |
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