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General NPI Number Information
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NPI Number | 1124001862
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Entity Type | Individual
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Provider Name | ROBERT A MAIRS DO
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Gender | Male
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Dates
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Enumeration Date | 11/28/2005
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 1050 SW 3RD AVE STE 3200
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City | ONTARIO
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State | OR
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Zip | 97914-4560
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Country | US
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Telephone | 541-881-2325
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Fax | 208-914-6701
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Provider Business Mailing Address
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Address Line | PO BOX 190930
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City | BOISE
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State | ID
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Zip | 83719-0930
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Country | US
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Telephone | 208-367-5170
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Fax | 208-367-5180
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | O-186
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | DO20644
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | DO20644
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License Number State | OR
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