Blackburn, Timothy L
Blackburn, Timothy L is an individual health care provider with primary practice located at 17067 S Outer Rd Suite 200, Belton MO 64012-2165. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Blackburn, Timothy L can be contacted via phone (816) 348-4281.Contact Information
Primary practice address
17067 S Outer Rd Suite 200
Belton MO 64012-2165
Phone: (816) 348-4281
Fax: (816) 348-4271
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | R2P33 | Missouri |
Profile Details
| NPI number | 1558325605 |
|---|---|
| LBN Legal business name | Blackburn, Timothy L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 14th, 2006 |
| Last updated | Sep 5th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558325605 | NPPES |
| Missouri | Other | 060066709 | RAILROAD MEDICARE |
| Missouri | MEDICAID | 1558325605 | RAILROAD MEDICARE |
| Missouri | Other | 17891028 | RAILROAD MEDICARE |
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