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Robert Mickelson
NPI 1205135498 · on the registry since 2011
Practice
- Address
- 2809 Cleveland Blvd
Caldwell, ID 83605 - Phone
- (208) 455-1094
- Fax
- (208) 455-1097
Registry record
- Primary taxonomy
- 183500000X
183500000X
- Licence states on file
- ID
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2011-03-28
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho