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General NPI Number Information
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NPI Number | 1285763862
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Entity Type | Individual
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Provider Name | ROBERT CHASE MCDONALD PA-C
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Gender | Male
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 11/08/2024
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Provider Practice Location Address
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Address Line | 1150 N SISTER CATHERINE WAY
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City | NAMPA
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State | ID
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Zip | 83687-3133
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Country | US
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Telephone | 208-302-7050
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Fax | 208-302-7055
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA10005181
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA-1451
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License Number State | ID
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