Individual
DR. ROBIN JACKSON DELEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 W FORT ST, PM&R, BOISE VA MEDICAL CENTER, BOISE, ID 83702-4501
(208) 422-1368
(208) 422-1188
Mailing address
8061 S DIEGO WAY, BOISE, ID 83709-7378
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
M-9583
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M-9583
MEDICAL LICENCE
ID
Enumeration date
09/01/2006
Last updated
03/07/2023
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