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Individual

ROBERT FORSYTH FALLON JR.

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
740 MCKINLEY AVE, KELLOGG, ID 83837
(208) 783-1267
Mailing address
25 JACOBS GULCH RD, KELLOGG, ID 83837-2023
(208) 784-7017
(208) 786-1019

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
M7400
ID

Other

Enumeration date
06/15/2006
Last updated
07/08/2007
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