Provider Demographics
NPI:1699062638
Name:ROBERTS, CALEB E (DPM)
Entity type:Individual
Prefix:
First Name:CALEB
Middle Name:E
Last Name:ROBERTS
Suffix:
Gender:
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 NORTHSTAR AVE
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-4073
Mailing Address - Country:US
Mailing Address - Phone:208-734-7676
Mailing Address - Fax:208-736-8378
Practice Address - Street 1:115 NORTHSTAR AVE
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-4073
Practice Address - Country:US
Practice Address - Phone:208-734-7676
Practice Address - Fax:208-736-8378
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCS35833213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery