NPI 1104394337

Lucas P Belford, PA

Practitioner Physician Assistant Blackfoot, ID

Practice location

Address: 700 E Alice St, Blackfoot, ID 83221-4925
Phone: (208) 785-1200
Mailing address: 909 E Reserve St, Boise, ID 83712-6508

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence PA-1676 (ID)

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Registry record

NPI: 1104394337
Entity type: Individual
Sex (as registered): Male
NPI issued: 6 Nov 2018
Record last updated: 21 Sep 2023

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.