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Kenneth Blackner, M.D
NPI 1043339641 · on the registry since 2007 · sole proprietor
Practice
- Address
- 275 W Locust St
Shelley, ID 83274 - Phone
- (208) 357-3960
- Organisation at this address
- Bmh Inc
Bingham Memorial HospitalInferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- General Practice Physician
208D00000X
- Also registered as
- General Practice Physician
- Licence states on file
- VA, ID
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2016-02-03
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho