Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. TIMOTHY ROGER BLACK, DPM
ActiveDR. TIMOTHY ROGER BLACK, DPM is a Podiatrist healthcare provider located in IDAHO FALLS, Idaho. NPI 1578753091 is currently active in the NPPES registry. Verify at CMS.
Podiatrist · IDAHO FALLS, ID
Registration Details
- NPI Number
- 1578753091
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 31, 2007 (18.849583161531 yrs)
- Last Updated
- Oct 31, 2017
- License
-
P-169 (ID)
Practice Information
- Address
-
3652 WASHINGTON PKWYIDAHO FALLS, ID, 834047573Browse ID providers · Browse ZIP 83404
- Phone
- 2085288700
- Fax
- 2085282802
- Primary Specialty
-
Podiatrist
213E00000X
Other Podiatrist Providers in IDAHO FALLS, ID
| Name | Credential | NPI |
|---|---|---|
| DR. JERRY D COOPER | D.P.M. | 1942299151 |
| ANDREW L MCCALL | D.P.M. P.A. | 1225065246 |
| DR. MICHAEL K. JAMES | DPM | 1629111497 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.