Richard Dale Blickenstaff in Boise - Procedural Dermatology
Richard Dale Blickenstaff - NPI 1265514582
Richard Dale Blickenstaff is a Procedural Dermatology in Boise, Idaho. Richard Dale Blickenstaff practices all healthcare services and medical treatments related to Procedural Dermatology. The NPI Number for Richard Dale Blickenstaff is 1265514582. The last update date is 2007-11-29.
Richard Dale Blickenstaff's current location address is 6454 W Emerald Street, Boise, Idaho. You can contact this provider via phone number 2083770820. The mailing address for Richard Dale Blickenstaff is 6454 W Emerald Street, Boise, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Richard Dale Blickenstaff |
|---|---|
| Address | 6454 W Emerald Street, Boise, Idaho |
| Phone Number | 2083770820 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1265514582 |
|---|---|
| Provider Enumeration Date | 2006-10-19 |
| Last Updated Date | 2007-11-29 |
Provider Mailing Address Detail
| Address | 6454 W Emerald Street |
|---|---|
| City | Boise |
| State | Idaho (ID) |
| Post Code | 837048734 |
| Phone Number | 2083770820 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Procedural Dermatology |
|---|---|
| Taxonomy | 207Ns0135X |
| Licence No | M-5274 |
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Definition: Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surge |
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What is the unique 10-digit identifier code issued to Richard Dale Blickenstaff by the Centers for Medicare & Medicaid Services?
The Richard Dale Blickenstaff has been assigned the NPI (National Provider Identifier) 1265514582 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you provide the complete address where Richard Dale Blickenstaff is physically located?
The Richard Dale Blickenstaff is situated at the following address: 6454 W Emerald Street, Boise, ID 837048734.
What is Richard Dale Blickenstaff's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Richard Dale Blickenstaff's specialized field of practice is Procedural Dermatology, and the corresponding taxonomy code that categorizes this area of specialization is 207Ns0135X.
On what date did the Richard Dale Blickenstaff receive the assignment of its 1265514582 from the Centers for Medicare & Medicaid Services?
The Richard Dale Blickenstaff was issued its 1265514582 by the Centers for Medicare & Medicaid Services on 2006-10-19.
When was the Richard Dale Blickenstaff's information last updated?
The Richard Dale Blickenstaff's information was last updated on 2007-11-29.