Timothy Roger Black in Idaho Falls - Podiatrist
Timothy Roger Black - NPI 1578753091
Timothy Roger Black is a Podiatrist in Idaho Falls, Idaho. Timothy Roger Black practices all healthcare services and medical treatments related to Podiatrist. The NPI Number for Timothy Roger Black is 1578753091. The last update date is 2017-10-31.
Timothy Roger Black's current location address is 1628 Elk Creek Dr, Idaho Falls, Idaho. You can contact this provider via phone number 2085288700 and fax number 2085282802. The mailing address for Timothy Roger Black is 1628 Elk Creek Dr, Idaho Falls, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Timothy Roger Black |
|---|---|
| Address | 1628 Elk Creek Dr, Idaho Falls, Idaho |
| Phone Number | 2085288700 |
| Fax Number | 2085282802 |
| Sole Proprietor | N |
| Credentials | DPM |
NPI Number Detail
| NPI Number | 1578753091 |
|---|---|
| Provider Enumeration Date | 2007-07-31 |
| Last Updated Date | 2017-10-31 |
Provider Mailing Address Detail
| Address | 1628 Elk Creek Dr |
|---|---|
| City | Idaho Falls |
| State | Idaho (ID) |
| Post Code | 834048349 |
| Phone Number | 2085288700 |
| Fax Number | 2085282802 |
Provider's Primary Taxonomy Detail
| Speciality | Podiatrist |
|---|---|
| Taxonomy | 213E00000X |
| Licence No | P-169 |
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Definition: A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical |
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Post Comment/ Review Below
What is the unique provider identifier assigned to Timothy Roger Black?
The Timothy Roger Black has been issued the NPI (National Provider Identifier) 1578753091 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please share the complete physical location address where Timothy Roger Black's facilities are situated?
The facilities of Timothy Roger Black are physically located at the following address: 1628 Elk Creek Dr, Idaho Falls, ID, 834048349.
What is the Timothy Roger Black's area of specialization and corresponding taxonomy classification?
The Timothy Roger Black's specialty field is Podiatrist, and it falls under the taxonomy code 213E00000X, which categorizes healthcare providers based on their specialties.
When was the Timothy Roger Black's 1578753091 issued?
The Timothy Roger Black's 1578753091 was issued on 2007-07-31.
When was the information pertaining to Timothy Roger Black most recently updated or revised?
The details related to Timothy Roger Black, including its address, specialty, and other relevant information, were last updated or revised on 2017-10-31.