MR. MARK MITCHELL ROUBIDOUX NPI 1629685235

NPI Information

MR. Mark Mitchell Roubidoux is an acute care nurse practitioner in Lewiston, ID. MR. Mark Mitchell Roubidoux NPI is 1629685235. 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:

201 18TH AVE
LEWISTON, ID
ZIP 83501-768
Phone: (208) 305-3537

The NPI 1629685235 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/28/2020 and was last updated on 9/28/2020.

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:

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