DR. RUSSELL R BLAKELEY M.D. NPI 1063409639

NPI Information

  • NPI: 1063409639
  • Provider Name: DR. RUSSELL R BLAKELEY, M.D.
  • Classification: Internal Medicine - 207RC0000X
  • Specialization: Cardiovascular Disease
  • Entity Type: Individual
  • Address: 606 N THIRD AVE
    SUITE 203
    SANDPOINT, ID
    ZIP 83864
  • Phone: (208) 263-8505

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NPI Details

DR. Russell R Blakeley, M.D. is a cardiovascular disease internal medicine in Sandpoint, ID. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. DR. Russell R Blakeley, M.D. NPI is 1063409639. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

606 N THIRD AVE
SUITE 203
SANDPOINT, ID
ZIP 83864-594
Phone: (208) 263-8505
Fax: (208) 263-2908

The enumeration date for this NPI number is 9/29/2005 and was last updated on 1/27/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RC0000XInternal MedicineCardiovascular Disease16299TENNESSEEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
13859385MEDICARE PINTENNESSEE
2103I060787MEDICARE PINTENNESSEE
3P00841514MEDICARE PIN
4D93197MEDICARE UPINTENNESSEE
53859386MEDICAIDTENNESSEE
6103I066492MEDICARE PINTENNESSEE
760068974MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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