Roubidoux, Mark Mitchell

Roubidoux, Mark Mitchell is an sole proprietor health care provider with primary practice located at 803 S Main St # 320 , Moscow ID 83843-2695. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Acute Care, which is considered as his primary health care specialty. Roubidoux, Mark Mitchell can be contacted via phone (208) 883-1008.

Contact Information

Primary practice address
803 S Main St # 320 Moscow ID 83843-2695
Phone: (208) 883-1008
Fax: (208) 883-4563
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 39235 Idaho

Profile Details

NPI number 1629685235
LBN Legal business name Roubidoux, Mark Mitchell
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 28th, 2020
Last updated Jul 19th, 2024 - about last year

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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