Kelly L Dustin, DO

NPI #1114957362 in Rexburg, Idaho

Provider Information

NPI Number: 1114957362
Entity Type: Individual
Name: Kelly L Dustin, DO
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Family Medicine
Credential: DO
Enumeration Date: Jul 4, 2006
Last Updated: Nov 19, 2019

Practice Location

Address: 21 WINN DR
City: Rexburg
State: Idaho
ZIP Code: 83440-5277
Phone: (208) 881-5222

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary
Student in an Organized Health Care Education/Training Program	390200000X

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