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:
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Health care specialties

SpecialtyCodeLicense #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 2 years 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558325605 NPPES
Missouri Other 060066709 RAILROAD MEDICARE
Missouri MEDICAID 1558325605 RAILROAD MEDICARE
Missouri Other 17891028 RAILROAD MEDICARE

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