OrganizationActive
Ada Dermatology, P.A.
NPI 1952483299 · Procedural Dermatology Physician · Boise, ID
Provider details
- NPI number
- 1952483299
- Entity type
- Organization
- Primary specialty
- Procedural Dermatology PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- Richard Blickenstaff, President
- License
- M-5274 (ID)
Mailing address
6454 W Emerald Street
Boise, ID 83704-8734
Registry dates
- Enumerated
- 2006-10-19
- Last updated
- 2012-01-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.