NPI 1770641193

Robert Blackston, CSTCSFA

Practitioner Surgical Assistant Coeur D Alene, ID

Practice location

Address: 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051
Phone: (208) 625-4000
Mailing address: 4768 W Princetown Ln, Coeur D Alene, ID 83815-5215

Registered specialties

Surgical Assistant Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 246ZC0007X Licence 143020 (ID)

Other Specialist/Technologist, Other providers in Idaho →

Registry record

NPI: 1770641193
Entity type: Individual
Sex (as registered): Male
NPI issued: 5 Dec 2006
Record last updated: 26 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.