Organization
IDAHO CLEFT AND CRANIOFACIAL PEDIATRIC PLASTIC SURGERY, P.A.
Active
Other names
Russell H Griffiths, MDPA
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL H GRIFFITHS MD (PRESIDENT)
(208) 433-1736
Entity
Organization
Contact information
Practice address
100 E IDAHO STREET, SUITE 303, BOISE, ID 83712-6269
(208) 433-1736
(208) 433-1738
Mailing address
100 E IDAHO STREET, SUITE 303, BOISE, ID 83712-6269
(208) 433-1736
(208) 433-1738
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
M7454
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805132700
—
ID
Enumeration date
04/23/2008
Last updated
05/08/2023
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