Individual
RICHARD MCCHRYSTAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
4809 W FAIRVIEW AVE, BOISE, ID 83706-2242
(208) 378-2840
(208) 323-9070
Mailing address
PO BOX 4236, BOISE, ID 83711-4236
(208) 378-2840
(208) 323-9070
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
RPA163
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010016027
RBSI
ID
01
—
PAPW1
BLUE CROSS
ID
Enumeration date
10/01/2006
Last updated
07/08/2007
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