Individual
DOUGLAS BLACKLIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2341 W LINCOLN RD, KOKOMO, IN 46902-8012
(844) 424-3668
(317) 575-6909
Mailing address
2341 W LINCOLN RD, KOKOMO, IN 46902-8012
(844) 424-3668
(317) 575-6909
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
070007898
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200058240
—
IN
Enumeration date
10/04/2006
Last updated
01/22/2024
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