Kenneth Todd Blackner
General Practice Physician
275 W Locust St
Shelley
, Idaho 83274-1230
Kenneth Todd Blackner
General Practice Physician
275 W Locust St
Shelley
, Idaho 83274-1230
(757) 617-3339
Write a Review Share Save Call
About
Features
Specialties
- General Practice Physician
Languages spoken
- English
Location
First Address
- Kenneth Todd Blackner
- 618 E 1450 N
- Shelley, ID
- Zip : 83274-5078
- Phone : (757) 617-3339
Second Address
- Kenneth Todd Blackner
- 275 W Locust St
- Shelley, ID
- Zip : 83274-1230
- Phone : (208) 357-3960
Reviews
FAQs
Where did Kenneth Todd Blackner attend graduate school?
Where did Kenneth Todd Blackner do his residency?
Where did Kenneth Todd Blackner do his fellowship?
Is Kenneth Todd Blackner board certified?
What type of doctor is Kenneth Todd Blackner
In what state does Kenneth Todd Blackner practice in?
Where is Kenneth Todd Blackner ’s practice located?
What is Kenneth Todd Blackner ’s gender?
Is Kenneth Todd Blackner a sole practitioner?
Is Kenneth Todd Blackner accepting new patients?
What languages does Kenneth Todd Blackner speak?
Does Kenneth Todd Blackner accept insurance?
Does Kenneth Todd Blackner offers telemedicine?
What is Kenneth Todd Blackner ’s professional license number?
What is Kenneth Todd Blackner ’s NPI number?
Does Kenneth Todd Blackner have any license restrictions?
Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 208D00000X | General Practice Physician | 0101240258 | VA |
| Y | 208D00000X | General Practice Physician | M-11785 | ID |
National Provider Identifier
| NPI | 1043339641 |
|---|---|
| Provider Name | Kenneth Todd Blackner |
| First Address | Shelley, ID 83274-5078 |
| Second Address | Shelley, ID 83274-1230 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 28/03/2007 |
| Last Update Date | 03/02/2016 |
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.