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Individual

ROBERT DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1055 N CURTIS RD, BOISE, ID 83706-1309
(208) 322-1730
(208) 322-1731
Mailing address
2963 E COPPER POINT DR, SUITE 150, MERIDIAN, ID 83642-9055
(208) 322-1730
(208) 322-1731

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD183619
OR
207P00000X
Emergency Medicine Physician
TL3776
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
807523000
ID
Enumeration date
07/11/2006
Last updated
01/23/2018
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