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ROBERT WYCLIFFE CHEATHAM III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3100 CHANNING WAY, IDAHO FALLS, ID 83404-7533
(208) 535-4591
Mailing address
1044 E QUARRY VISTA CIR, SANDY, UT 84094-4095
(208) 535-4591

Taxonomy

Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
5181544-1205
UT
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
M-12972
ID
2080P0203X
Pediatric Critical Care Medicine Physician
M-12972
ID

Other

Enumeration date
06/30/2006
Last updated
04/25/2016
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