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Search › Oklahoma › 122300000X

Ty Blacker, DMD

NPI 1336813534 · on the registry since 2021 · sole proprietor

Practice

Address
605 Randolph Rd
Fort Sill, OK 73503
Phone
(580) 442-5925
Fax
(580) 442-7147
Organisation at this address
Reynolds Army Community Hospital
Inferred from a shared address, not stated in the registry.
Clinicians at this address
29

Registry record

Primary taxonomy
122300000X
122300000X
Licence states on file
FL
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2023-04-11

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 Oklahoma