person
Roger David Cushman, PA
Medical Physician Assistant in Pocatello, Idaho
NPI 1578742615

Roger David Cushman is a Medical Physician Assistant based in Pocatello, ID and is specialized in Medical. Roger David Cushman practices in Pocatello, ID and has the professional credentials of PA. The NPI Number for Roger David Cushman is 1578742615 and holds a License No. GPA-034 (Idaho).

The current practice location address for Roger David Cushman is 2302 E. Terry Street, Pocatello, ID and can be reached out via phone at 208-235-5910.

Location: 2302 E. Terry Street, Pocatello, ID, 83204-0335
person
Provider Profile Details
NPI Number
1578742615
Provider Name
Roger David Cushman
Credential
PA
Provider Entity Type
Individual
Gender
Male
Address
2302 E. Terry Street, Pocatello, ID, 83204-0335
Phone Number
208-235-5910
Fax Number
Provider Enumeration Date
10/25/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
2302 E. Terry Street
City
State
Zip
83201
Phone Number
208-235-5910
Fax Number
person
Provider Business Mailing Address Details
Address
2302 E. Terry Street
City
State
Zip
83201
Phone Number
208-235-5910
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
GPA-034 (Idaho)
Definition
Definition to come...
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