Kerry Alan Blackham in Philip - Geriatric Medicine

Kerry Alan Blackham - NPI 1922014273

Kerry Alan Blackham is a Geriatric Medicine in Philip, South Dakota. Kerry Alan Blackham practices all healthcare services and medical treatments related to Geriatric Medicine. The NPI Number for Kerry Alan Blackham is 1922014273. The last update date is 2019-01-09.

Kerry Alan Blackham's current location address is 503 West Pine, Philip, South Dakota. You can contact this provider via phone number 6058592566 and fax number 6058592948. The mailing address for Kerry Alan Blackham is 503 West Pine, Philip, South Dakota. To know further, please read the information below!

Provider Profile Detail

Provider Name Kerry Alan Blackham
Address 503 West Pine, Philip, South Dakota
Phone Number 6058592566
Fax Number 6058592948
Sole Proprietor Y
Credentials DO

NPI Number Detail

NPI Number 1922014273
Provider Enumeration Date 2006-07-31
Last Updated Date 2019-01-09

Provider Mailing Address Detail

Address 503 West Pine
City Philip
State South Dakota (SD)
Post Code 575670550
Phone Number 6058592566
Fax Number 6058592948

Provider's Primary Taxonomy Detail

Speciality Geriatric Medicine
Taxonomy 207Qg0300X
Licence No 9452
Definition:
A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's

Provider's Other Legacy Identifiers

Identifier Identifier Type Identifier State Identifier Issuer
S110986 SD --

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FAQs about Kerry Alan Blackham

What is the unique 10-digit identification code assigned to Kerry Alan Blackham by the Centers for Medicare & Medicaid Services?

The Kerry Alan Blackham has been issued the NPI (National Provider Identifier) 1922014273, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).

Could you provide the complete physical address where Kerry Alan Blackham is located?

The Kerry Alan Blackham is situated at the following address: 503 West Pine, Philip, SD, 575670550.

What is Kerry Alan Blackham's specialized area of practice, and what is the corresponding taxonomy classification code for this field?

The Kerry Alan Blackham's specialized field of practice is Geriatric Medicine, and the corresponding taxonomy code that categorizes this area of specialization is 207Qg0300X.

When did Kerry Alan Blackham receive its 1922014273 assignment?

The Kerry Alan Blackham was assigned its 1922014273 on 2006-07-31, which is the date when this unique identifier was issued to the organization.

As of what date were the details pertaining to Kerry Alan Blackham last refreshed?

The information related to the Kerry Alan Blackham, including its address, specialty, and other relevant details, was last updated on 2019-01-09.

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