Tanner Mitton, PA-C

NPI 1144601865 · on the registry since 2015

Practice

Address: 1355 Parkway Dr Ste A
Blackfoot, ID 83221
Phone: (986) 275-0003
Fax: (986) 275-0005
Organisation at this address: Wray Dermatology
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 2

Registry record

Primary taxonomy: 363A00000X
363A00000X
Also registered as: 363A00000X
Licence states on file: ID
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2026-06-30

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho