Organization
KAYNE KISHIYAMA MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAYNE K KISHIYAMA M.D. (OWNER)
(208) 552-0920
Entity
Organization
Contact information
Practice address
1522 ELK CREEK DR, IDAHO FALLS, ID 83404-8322
(208) 552-0920
(208) 529-2564
Mailing address
1522 ELK CREEK DR, IDAHO FALLS, ID 83404-8322
(208) 552-0920
(208) 529-2564
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
05/20/2008
Last updated
05/20/2008
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