Healthcare Provider Details

I. General information

NPI: 1619966140
Provider Name (Legal Business Name): WILLIAM PAUL ROBISON D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2005
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1511 3RD ST S
NAMPA ID
83651-4307
US

IV. Provider business mailing address

1511 3RD ST S
NAMPA ID
83651-4307
US

V. Phone/Fax

Practice location:
  • Phone: 208-936-4463
  • Fax: 208-936-4468
Mailing address:
  • Phone: 208-936-4463
  • Fax: 208-936-4468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC-1040
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHIA-1000
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: