Blacklidge, Douglas
Blacklidge, Douglas is an individual health care provider with primary practice located at 2341 W Lincoln Rd , Kokomo IN 46902-8012. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Blacklidge, Douglas can be contacted via phone (844) 424-3668.Contact Information
Primary practice address
2341 W Lincoln Rd
Kokomo IN 46902-8012
Phone: (844) 424-3668
Fax: (317) 575-6909
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery | 213ES0103X | 070007898 | Indiana |
Profile Details
| NPI number | 1003901133 |
|---|---|
| LBN Legal business name | Blacklidge, Douglas |
| Credentials | Doctor of Podiatric Medicine (DPM) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 4th, 2006 |
| Last updated | Jan 22nd, 2024 - about 11 months ago |
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 | 1003901133 | NPPES |
| Indiana | MEDICAID | 200058240 |
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