# INLAND PEDIATRIC OPHTHALMOLOGY AND STRABISMUS P.L.L.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104472349
- **Authorized official:** SONYA THOMAS BLIZZARD MD (PHYSICIAN)
- **Authorized official phone:** (208) 274-3937

## Contact information

- **Practice address:** 2175 N MAIN ST, COEUR D ALENE, ID 83814-5768
- **Practice address phone:** (208) 664-9888
- **Practice address fax:** (208) 666-0816
- **Mailing address:** 2600 E SELTICE WAY, STE A PMB\#277, POST FALLS, ID 83854

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207WX0110X | Pediatric Ophthalmology and Strabismus Specialist Physician | — | NULL | Yes |
| 207WX0110X | Pediatric Ophthalmology and Strabismus Specialist Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/14/2019
- **Last updated:** 02/10/2020