IndividualActive
Brandon Wilde, D.P.M.
NPI 1407169865 · Foot & Ankle Surgery Podiatrist · Pocatello, ID
Provider details
- NPI number
- 1407169865
- Entity type
- Individual
- Primary specialty
- Foot & Ankle Surgery PodiatristPodiatric Medicine & Surgery Service Providers
- Credential
- D.P.M.
- Sex
- Male
- Sole proprietor
- Yes
- License
- P-217 (ID)
Specialties & taxonomies
Podiatric Medicine & Surgery Service Providers
Practice location
1455 Bench Rd Ste B
Pocatello, ID 83201-5084
Phone: (208) 232-0006
Fax: (208) 233-8771
Approximate (ZIP-level) locationGet directions
Mailing address
1455 Bench Rd
Pocatello, ID 83201-5083
Additional practice locations (1)
- 10 S 1st W Ste BPreston, ID 83263-1244Phone: (208) 232-0006Fax: (208) 233-8771
Registry dates
- Enumerated
- 2010-07-14
- Last updated
- 2026-03-05
- Certified
- 2026-03-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.