OrganizationActive
Upper Valley Ent & Allergy PLLC
NPI 1124462494 · Otolaryngology/Facial Plastic Surgery Physician · Rexburg, ID
Provider details
- NPI number
- 1124462494
- Entity type
- Organization
- Primary specialty
- Otolaryngology/Facial Plastic Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jay Mcmaster, Physician/Surgeon(208) 656-9646
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Allergy Physician207KA0200X
Allopathic & Osteopathic Physicians
- Medical Physician Assistant363AM0700X
Physician Assistants & Advanced Practice Nursing Providers
Practice location
256 N 2nd E
Rexburg, ID 83440-1638
Phone: (208) 656-9646
Fax: (208) 656-9645
Approximate (ZIP-level) locationGet directions
Mailing address
256 N 2nd E
Rexburg, ID 83440-1638
Registry dates
- Enumerated
- 2013-04-17
- Last updated
- 2014-06-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.