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Individual

MR. MARK LUPTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
700 E ALICE ST, BLACKFOOT, ID 83221-4925
(208) 785-1200
Mailing address
PO BOX 400, BLACKFOOT, ID 83221-0400
(208) 785-1200

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OO-0994
ID

Other

Enumeration date
06/16/2016
Last updated
08/10/2022
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