| Doctor Name: | DR. RUSSELL R BLAKELEY |
| NPI Number: | 1063409639 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 16299 |
| Business Practice Address: | 606 N Third Ave Suite 203 Sandpoint, ID - 838641594 |
| Business Phone Number: | 2082638505 |
| Business Fax Number: | 2082632908 |
| Mailing Address: | 2003 Kootenai Health Way, COEUR D ALENE |
| State: | ID |
| Postal Code: | 838146051 |
| Phone Number: | 2086525250 |
| Fax Number: | 2086255251 |
| NPI Enumeration Date: | 09/29/2005 |
| NPI Last Update Date: | 01/27/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207RC0000X |
| License Number: | 16299 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Internal Medicine |
| Taxonomy Specialization: | Cardiovascular Disease |
| Taxonomy Definition: | An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |