Richard Dale Blickenstaff (NPI# 1265514582, PAC ID# 9032207220) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DERMATOLOGY.
| Nation Provider ID (NPI) | 1265514582 |
| PAC ID by PECOS | 9032207220 |
| Professional Enrollment ID | I20071126000167 |
| Full Name | Richard Dale Blickenstaff |
| Organization Legal Name | ADA DERMATOLOGY, P.A. |
| Address |
6454 W Emerald St Boise ID 83704-8734 |
| Phone Number | 2083770820 |
| Gender | M |
| Medical School | UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE |
| Graduation Year | 1982 |
| Primary Specialty | DERMATOLOGY |
| Group Practice PAC ID | 5395833586 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | M |
| Address | Phone | Organization |
|---|---|---|
| 6454 W Emerald St, Boise, ID 83704-8734 | 2083770820 | ADA DERMATOLOGY, P.A. |
| Organization Legal Name | ADA DERMATOLOGY, P.A. |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Rachel M King | Physician Assistant | Ada Dermatology, P.a. | 6454 W Emerald St, Boise, ID 83704-8734 |
| Street Address |
6454 W EMERALD ST |
| City | BOISE |
| State | ID |
| Zip | 83704-8734 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Rachel M King | Physician Assistant | Ada Dermatology, P.a. | 6454 W Emerald St, Boise, ID 83704-8734 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tobin E Hill | Nurse Practitioner | Saint Alphonsus Specialty Services Inc | 6140 W Curtisian Ave, 200 Samg Heart Care Boise Moreau, Boise, ID 83704-0107 |
| Adrian J Curnow | Pediatric Medicine | Saint Alphonsus Specialty Services Inc | 6140 W Curtisian Ave, 200 Samg Heart Care Boise Moreau, Boise, ID 83704-0107 |
| Julia K Bouchard | Obstetrics/gynecology | Saint Alphonsus Specialty Services Inc | 6140 W Curtisian Ave, 200 Samg Heart Care Boise Moreau, Boise, ID 83704-0107 |
| Steven J Fonken | Interventional Cardiology | Saint Alphonsus Specialty Services Inc | 6140 W Curtisian Ave, Boise, ID 83704-0107 |
| Ellis J Salloum | Vascular Surgery | Saint Alphonsus Regional Medical Center Inc | 6140 W Curtisian Ave, Boise, ID 83704-0109 |
| Samantha J Benfield | Nurse Practitioner | Saint Alphonsus Specialty Services Inc | 6140 W Curtisian Ave, 102 Samg Cardiothoracic Services Boise, Boise, ID 83704-0109 |
| Calvin T Jewell | General Surgery | Saint Alphonsus Specialty Services Inc | 6140 W Curtisian Ave, 100 Samg General Surgery Suite 100, Boise, ID 83704-0109 |
| Noah Blue Edvalson | Chiropractic | 3224 N Maple Grove Rd, Boise, ID 83704-4214 | |
| Christopher A Waters | Clinical Psychologist | Living Hope Clinic Inc | 3308 N Cole Rd A, Boise, ID 83704-4407 |
| Charles M Rice | Psychologist, Clinical | 3308 N Cole Rd, Suite A, Boise, ID 83704-4407 | |
| Find all physicians in zip 83704 | |||
| City | BOISE |
| Zip Code | 83704 |
| Specialty | DERMATOLOGY |
| City + Specialty | BOISE + DERMATOLOGY |
Please comment or provide details below to improve the information on Richard Dale Blickenstaff.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.