Organization
P. ROMAN BURK DPM PC
Active
Other names
Rocky Mountaint Foot & Ankle
Organization subpart
No
Provider details
NPI number
Authorized official
DR. P ROMAN BURK DPM (OWNER)
(208) 855-5955
Entity
Organization
Contact information
Practice address
2667 E GALA CT STE 130, MERIDIAN, ID 83642-2788
(208) 795-5090
Mailing address
1818 S 10TH AVE, #250, CALDWELL, ID 83605-4803
(208) 855-5955
(208) 459-8628
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
P197
ID
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
P197
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000000154263
REGENCE
ID
05
—
808001900
—
ID
01
—
P9383
BLUE CROSS
ID
Enumeration date
05/27/2011
Last updated
09/13/2022
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