Douglas Blacklidge
Foot & Ankle Surgery
2341 W Lincoln Rd
Kokomo
, Indiana 46902-8012
Douglas Blacklidge
Foot & Ankle Surgery
2341 W Lincoln Rd
Kokomo
, Indiana 46902-8012
(317) 575-6909
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About
Features
Specialties
- Foot & Ankle Surgery
Languages spoken
- English
Location
First Address
- Douglas Blacklidge
- 2341 W Lincoln Rd
- Kokomo, IN
- Zip : 46902-8012
- Fax : (317) 575-6909
- Phone : (844) 424-3668
Second Address
- Douglas Blacklidge
- 2341 W Lincoln Rd
- Kokomo, IN
- Zip : 46902-8012
- Fax : (317) 575-6909
- Phone : (844) 424-3668
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Is Douglas Blacklidge a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 213ES0103X | Foot & Ankle Surgery | 070007898 | IN |
National Provider Identifier
| NPI | 1003901133 |
|---|---|
| Provider Name | Douglas Blacklidge |
| First Address | Kokomo, IN 46902-8012 |
| Second Address | Kokomo, IN 46902-8012 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 04/10/2006 |
| Last Update Date | 17/03/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 200058240 | (05) | IN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.