person
Timothy Blackstad, DO
Student in an Organized Health Care Education/Training Program in Tulsa, Oklahoma
NPI 1396523643

Timothy Blackstad is a Student in an Organized Health Care Education/Training Program based in Broken Arrow, OK. Timothy Blackstad practices in Tulsa, OK and has the professional credentials of DO. The NPI Number for Timothy Blackstad is 1396523643 and holds a License No. (Oklahoma).

The current practice location address for Timothy Blackstad is 1111 W 17Th St, Tulsa, OK and can be reached out via phone at 918-582-1972.

Location: 1111 W 17Th St, Tulsa, OK, 74012-9419
person
Provider Profile Details
NPI Number
1396523643
Provider Name
Timothy Blackstad
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
1111 W 17Th St, Tulsa, OK, 74012-9419
Phone Number
918-582-1972
Fax Number
Provider Enumeration Date
09/18/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1111 W 17Th St
City
State
Zip
74107-1886
Phone Number
918-582-1972
Fax Number
person
Provider Business Mailing Address Details
Address
1111 W 17Th St
City
State
Zip
74107-1886
Phone Number
918-582-1972
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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