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