Killpack, Ryan Blair

Killpack, Ryan Blair is an individual health care provider with primary practice located at 98 Poplar St , Blackfoot ID 83221-1758. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is his primary health care specialty. Killpack, Ryan Blair can be contacted via phone (208) 785-4100.

Contact Information

Primary practice address
98 Poplar St Blackfoot ID 83221-1758
Phone: (208) 785-4100
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X

Profile Details

NPI number 1114405396
LBN Legal business name Killpack, Ryan Blair
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 31st, 2018
Last updated Jul 31st, 2018 - about 7 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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