Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | P-204 | ID |
NPI | 1013139898 |
---|---|
Provider Name | Dan Earl Robinson |
First Address | Blackfoot, ID 83221-1758 |
Second Address | Blackfoot, ID 83221-1758 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2007 |
Last Update Date | 27/02/2013 |