Provider Demographics
NPI:1942029582
Name:EMERY, CURTIS PHILLIP (RT (R)(CT))
Entity type:Individual
Prefix:
First Name:CURTIS
Middle Name:PHILLIP
Last Name:EMERY
Suffix:
Gender:M
Credentials:RT (R)(CT)
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:116 KEY HOLE DR
Mailing Address - Street 2:
Mailing Address - City:JEROME
Mailing Address - State:ID
Mailing Address - Zip Code:83338-5201
Mailing Address - Country:US
Mailing Address - Phone:208-404-8413
Mailing Address - Fax:208-814-9592
Practice Address - Street 1:709 N LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:JEROME
Practice Address - State:ID
Practice Address - Zip Code:83338-1851
Practice Address - Country:US
Practice Address - Phone:208-814-9729
Practice Address - Fax:208-814-9592
Is Sole Proprietor?:No
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ID4845122471C3401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C3401XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistComputed Tomography