Individual
ROBERT CROUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
9850 W ST LUKES DR # 329, NAMPA, ID 83687-7912
(208) 514-2509
(208) 375-2217
Mailing address
777 N RAYMOND ST, BOISE, ID 83704-9251
(208) 514-2500
(208) 375-2217
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MRO-1490
ID
207Q00000X
Family Medicine Physician
Primary
O-1030
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164801692
—
ID
Enumeration date
05/29/2015
Last updated
12/15/2023
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