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General NPI Number Information
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NPI Number | 1144255639
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Entity Type | Individual
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Provider Name | KEVIN BURTON STRAIT DO
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Gender | Male
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 08/22/2024
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Provider Practice Location Address
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Address Line | 1551 E MULLAN AVE STE 200C
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City | POST FALLS
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State | ID
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Zip | 83854-9005
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Country | US
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Telephone | 208-618-2570
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Fax | 208-618-8779
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Provider Business Mailing Address
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Address Line | 1593 E POLSTON AVE
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City | POST FALLS
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State | ID
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Zip | 83854-5326
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Country | US
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Telephone | 208-262-2300
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Fax | 208-262-7461
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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 | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | O-0423
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | O-0423
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License Number State | ID
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