Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | M-10754 | ID |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | M-10754 | ID |
NPI | 1801010541 |
---|---|
Provider Name | Dr. Jason F Robison |
First Address | Boise, ID 83712-6241 |
Second Address | Boise, ID 83702 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2007 |
Last Update Date | 04/09/2012 |