Provider

BLAKE ANDERSON DO

Public NPPES listing with taxonomy: Student in an Organized Health Care Education/Training Program.

Resource details

Medicare status: Confirm directly

Unknown from NPPES

Source: NPPES NPI Registry

NPI: 1063271641

Taxonomy: Student in an Organized Health Care Education/Training Program (390200000X)

Source confidence: 58%

Medicare assignment: Unknown from NPPES

Address: 3100 CHANNING WAY, IDAHO FALLS, ID, 834047533

Phone: 208-227-2850

Last verified: May 15, 2026