Kenneth Todd Blackner in Shelley - General Practice
Kenneth Todd Blackner - NPI 1043339641
Kenneth Todd Blackner is a General Practice in Shelley, Idaho. Kenneth Todd Blackner practices all healthcare services and medical treatments related to General Practice. The NPI Number for Kenneth Todd Blackner is 1043339641. The last update date is 2016-02-03.
Kenneth Todd Blackner's current location address is 618 E 1450 N, Shelley, Idaho. You can contact this provider via phone number 7576173339. The mailing address for Kenneth Todd Blackner is 618 E 1450 N, Shelley, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kenneth Todd Blackner |
|---|---|
| Address | 618 E 1450 N, Shelley, Idaho |
| Phone Number | 7576173339 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1043339641 |
|---|---|
| Provider Enumeration Date | 2007-03-28 |
| Last Updated Date | 2016-02-03 |
Provider Mailing Address Detail
| Address | 618 E 1450 N |
|---|---|
| City | Shelley |
| State | Idaho (ID) |
| Post Code | 832745078 |
| Phone Number | 7576173339 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 208D00000X |
| Licence No | 101240258 |
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Definition: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. |
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Post Comment/ Review Below
What is the Kenneth Todd Blackner's 1043339641?
The Kenneth Todd Blackner's NPI (National Provider Identifier) Number is 1043339641. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Kenneth Todd Blackner is physically located?
The Kenneth Todd Blackner is situated at the following address: 618 E 1450 N, Shelley, ID 832745078.
What is Kenneth Todd Blackner's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Kenneth Todd Blackner is General Practice, and the corresponding taxonomy classification code for this specialized field is 208D00000X.
On what date did Kenneth Todd Blackner receive its 1043339641 assignment from the Centers for Medicare & Medicaid Services?
The Kenneth Todd Blackner was assigned its 1043339641 on 2007-03-28, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details related to Kenneth Todd Blackner most recently updated or revised?
The information pertaining to Kenneth Todd Blackner, including its address, specialty, and other relevant details, was last updated or revised on 2016-02-03.