NPI 1306832688

Kenneth John Wakefield, MD

Practitioner Allergy Physician Coeur D Alene, ID

Practice location

Address: 3731 N Ramsey Rd Suite 150, Coeur D Alene, ID 83815-9000
Phone: (208) 665-1552
Fax: (208) 665-1558
Mailing address: 4304 N 16th St, Coeur D Alene, ID 83815-9414

Registered specialties

Allergy Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207KA0200X Licence M-9596 (ID)

Other Allergy & Immunology providers in Idaho →

Registry record

NPI: 1306832688
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 Sep 2005
Record last updated: 13 Feb 2008

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.