Blickenstaff, Richard Dale

Blickenstaff, Richard Dale is an sole proprietor health care provider with primary practice located at 6454 W Emerald Street , Boise ID 83704-8734. He recently has only one registered license in Allopathic & Osteopathic Physicians / Procedural Dermatology, which is considered as his primary health care specialty. Blickenstaff, Richard Dale can be contacted via phone (208) 377-0820.

Contact Information

Primary practice address
6454 W Emerald Street Boise ID 83704-8734
Phone: (208) 377-0820
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Procedural Dermatology 207NS0135X M-5274 Idaho

Profile Details

NPI number 1265514582
LBN Legal business name Blickenstaff, Richard Dale
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 19th, 2006
Last updated Nov 29th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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