Healthcare Provider Details

I. General information

NPI: 1982937066
Provider Name (Legal Business Name): DON H CURTIS CSFA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2009
Last Update Date: 06/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

348 W BLOOMINGTON DR
MERIDIAN ID
83642-6942
US

IV. Provider business mailing address

348 W BLOOMINGTON DR
MERIDIAN ID
83642-6942
US

V. Phone/Fax

Practice location:
  • Phone: 208-866-8277
  • Fax:
Mailing address:
  • Phone: 208-866-8277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number116257
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number116257
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: