Roger David Cushman, P.A.

NPI #1578742615 in Pocatello, Idaho

Provider Information

NPI Number
1578742615
Entity Type
Individual
Name
Roger David Cushman, P.A.
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Physician Assistant - Medical
Credential
P.A.
Enumeration Date
Oct 25, 2007
Last Updated
Oct 25, 2007

Practice Location

Address
2302 E. TERRY STREET
State
Idaho
ZIP Code
83201
Phone
(208) 235-5910

Specialties & Taxonomy Codes

Specialty
Physician Assistant - MedicalMedical

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