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Organization

VALLEY RADIATION PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROBERT KENNETH FAIRBANKS MD (SOLE MEMBER)
(509) 993-7197
Entity
Organization

Contact information

Practice address
504 6TH ST, LEWISTON, ID 83501-2439
(208) 799-5600
(530) 799-5755
Mailing address
PO BOX 239, LEWISTON, ID 83501-0239
(208) 799-5600
(208) 799-5755

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary

Other

Enumeration date
08/02/2024
Last updated
03/18/2026
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