NPI age
20 years
Enumerated 2005-10-18
● Active
Type 1 · Individual
DR. Bruce E. Gollub, M.D.
Gollub is 1 of 57 family medicine providers in Twin Falls and 1 of 1691 in Idaho.
Primary specialty
Family Medicine
Plus 2 subspecialties
Licensed in
ID, NM
2 states
Status
Active
No deactivations on record
Last NPPES update
2023-11-30
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 1691 active family medicine providers in Idaho.
NPI age
20 years
↑ 3 yr above median (17 yr)
State licenses
2 states
Top 85% — 14% of peers are multi-state
Subspecialties
1
In the 31% of peers with subspecialties
NPI lifetime · 2005 → 2026
2005-10Enumerated in NPPES
2005
2026
Where they practice
Practice location
775 Pole Line Rd W Ste 103
Twin Falls, ID 833015819
Mailing address
190 E Bannock St
Boise, ID 837126241
Additional practice locations
2 secondary locations on file with NPPES.
Location 2
401 Botulph Ln
Santa Fe, NM 875056912
Location 3
660 2nd Ave. S. Apt A
Ketchum, ID 83340
Specialties
-
Family Medicine PrimaryFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of...
-
General PracticeA physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (NM) | 22491 |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
Provyx · Custom healthcare lists
Need all 1691 Family Medicine providers in Idaho?
Get the full list as a CSV with verified work emails, direct phones, and LinkedIn URLs.
Request a quote →How to verify this provider
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.