Provider Demographics
NPI:1598707226
Name:HEMPHILL, BRYON D (DO)
Entity Type:Individual
Prefix:DR
First Name:BRYON
Middle Name:D
Last Name:HEMPHILL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 NE 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:PAYETTE
Mailing Address - State:ID
Mailing Address - Zip Code:83661-5420
Mailing Address - Country:US
Mailing Address - Phone:208-642-9376
Mailing Address - Fax:208-642-9598
Practice Address - Street 1:896 FORTNER ST
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:OR
Practice Address - Zip Code:97914-1787
Practice Address - Country:US
Practice Address - Phone:415-881-2828
Practice Address - Fax:541-881-2808
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID0-244207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR135456OtherMEDICARE PART B
ID805781100Medicaid
ID1302148OtherMEDICARE PART B
ID805781100Medicaid