Russell R Blakeley M.D.

NPI 1063409639 - Internal Medicine - 207RC0000X

NPI Details
NPI 1063409639
Gender Male
Enumeration Date 09/29/2005
Last Updated 01/27/2016
Entity Type Individual
Active Over 11 years ago
Practice Location
606 N THIRD AVE
SUITE 203
SANDPOINT ID, 83864-1594, US
Phone (208) 263-8505
Fax (208) 263-2908
Business Location
2003 KOOTENAI HEALTH WAY
COEUR D ALENE ID, 83814-6051, US
Phone (208) 652-5250
Fax (208) 625-5251
Toxanomy
Taxonomy Code 207RC0000X
License State Tennessee
License Number 16299
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According to our database, Dr. Russell R Blakeley M.D. NPI is 1063409639, taxonomy code is 207RC0000X and license number is 16299, license state is located at Tennessee. Russell R Blakeley M.D. physically located at 606 N Third Ave, Sandpoint ID, 83864-1594. NPI Number Russell R Blakeley M.D. has the Individual type.

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1063409639 NPI number is provided on an as is basis without warranty of any kind. 1063409639 is maintained by the National Plan & Provider Enumeration System. The contents of Russell R Blakeley M.D. are for informational purposes only.