Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Bruce E. Gollub, MD

Individual provider Family Medicine Physician · NPI 1508855917

Dr. Bruce E. Gollub, MD is a Family Practice in Twin Falls, Idaho. Graduated from University of Missouri, Columbia School of Medicine in 1979, 47 years ago. Practices with Ketchum Family Medicine, PLLC, a 2-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Idaho and New Mexico.

Years since qualifying
47
Trained at
University of Missouri, Columbia School of Medicine
Licensed in
ID, NM
In the registry since
2005
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

775 Pole Line Rd W Ste 103
Twin Falls, ID 83301-5819
Phone: (208) 814-8375
Fax: (208) 814-8376
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 660 2nd Ave. S. Apt A, Ketchum, ID 83340 — (208) 622-3180
  • 401 Botulph Ln, Santa Fe, NM 87505-6912 — (505) 983-8387

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence M-17332 (ID)
Family Medicine Physician Taxonomy 207Q00000X · Licence 80-158 (NM)
General Practice Physician Taxonomy 208D00000X · Licence 80-158 (NM)

Record details

NPI number1508855917
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedOctober 18, 2005
Last updated in NPPESNovember 30, 2023
Certification dateNovember 30, 2023
Mailing address190 E Bannock St, Boise, ID 83712-6241

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolUNIVERSITY OF MISSOURI, COLUMBIA SCHOOL OF MEDICINE
Graduated 1979 (47 years in practice)
Group practice Ketchum Family Medicine, Pllc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Twin Falls