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James L Blaine, PA-C
Medical Physician Assistant in Pocatello, Idaho
NPI 1801963459

James L Blaine is a Medical Physician Assistant based in Pocatello, ID and is specialized in Medical. James L Blaine practices in Pocatello, ID and has the professional credentials of PA-C. The NPI Number for James L Blaine is 1801963459 and holds a License No. PA-353 (Idaho).

The current practice location address for James L Blaine is 1448 E Center St Ste E, Pocatello, ID and can be reached out via phone at 208-234-1300 and via fax at 208-234-1333.

Location: 1448 E Center St Ste E, Pocatello, ID, 83201-4132
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Provider Profile Details
NPI Number
1801963459
Provider Name
James L Blaine
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
1448 E Center St Ste E, Pocatello, ID, 83201-4132
Phone Number
208-234-1300
Fax Number
208-234-1333
Provider Enumeration Date
11/29/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1801963459 05 ID
1667204 01 ID MEDICARE PTAN
institution
Provider Business Practice Location Address Details
Address
1448 E Center St Ste E
City
State
Zip
83201-4132
Phone Number
208-234-1300
Fax Number
208-234-1333
person
Provider Business Mailing Address Details
Address
1448 E Center St Ste E
City
State
Zip
83201-4132
Phone Number
208-234-1300
Fax Number
208-234-1333
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
PA-353 (Idaho)
Definition
Definition to come...
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