NPI 1548758501

Mountain West Derm-Blackhart, PLLC

Organisation Dermatology Physician Boise, ID

Practice location

Address: 7733 W Emerald St, Boise, ID 83704-9020
Phone: (208) 939-4599
Fax: (208) 939-5010
Mailing address: 201 Franklin Rd Fl 3, Brentwood, TN 37027-5214

Authorised official

Name: Bret S Blackhart
Title: Owner
Phone: (775) 336-3624

Registered specialties

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X

Other Dermatology providers in Idaho →

Registry record

NPI: 1548758501
Entity type: Organization
NPI issued: 25 Apr 2018
Record last updated: 25 Apr 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.