NPI 1003901133 · live from the CMS NPI Registry
Douglas Blacklidge, DPM
Podiatrist, Foot & Ankle Surgery in Kokomo, IN. National Provider Identifier 1003901133, active.
NPI record
| NPI | 1003901133 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Podiatrist, Foot & Ankle Surgery 213ES0103X |
| Practice location | 2341 W Lincoln Rd, Kokomo, IN 46902 |
| Practice phone | 844-424-3668 |
| Enumerated | October 4, 2006 |
| Last updated | January 22, 2024 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist, Foot & Ankle Surgery primary | 213ES0103X | 070007898 (IN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.