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Individual

KARSON FAWCETT KALIAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
4424 E FLAMINGO AVE STE 210, NAMPA, ID 83687-9291
(208) 302-2000
(208) 302-2108
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 367-5170
(208) 367-5180

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
8336
NE
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
O-1900
ID
207RP1001X
Pulmonary Disease Physician
Primary
O-1900
ID

Other

Enumeration date
04/16/2018
Last updated
08/06/2025
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