Provider Demographics
NPI:1386737989
Name:G ADRIAN DEAN MD INC
Entity type:Organization
Organization Name:G ADRIAN DEAN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:G.
Authorized Official - Middle Name:ADRIAN
Authorized Official - Last Name:DEAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:208-944-4727
Mailing Address - Street 1:709 CANYON PARK AVE
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-3054
Mailing Address - Country:US
Mailing Address - Phone:208-944-4727
Mailing Address - Fax:208-944-4646
Practice Address - Street 1:709 CANYON PARK AVE
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-3054
Practice Address - Country:US
Practice Address - Phone:208-944-4727
Practice Address - Fax:208-944-4646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM-50182084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID8E787OtherBLUE CROSS
ID8E787OtherBLUE CROSS