Dennis a Blackburn, D.P.M.

Primary specialty

PodiatristTaxonomy code 213E00000X

License

103173-0501 Issued in UT

Legal business name

DENNIS A BLACKBURN, D.P.M.

Practice address

250 N Fairgrounds Rd
Suite #3
Price, UT 84501-4203

Phone

(435) 637-6797

Fax

(435) 637-6799

NPI assigned

Dec 5, 2007

Last updated

Dec 5, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Dennis A Blackburn, D.P.M.

Title

Owner

Phone

(435) 637-6797

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196812800000",
    "number": "1235311838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N FAIRGROUNDS RD",
            "address_2": "SUITE #3",
            "city": "PRICE",
            "state": "UT",
            "postal_code": "845014203",
            "telephone_number": "435-637-6797",
            "fax_number": "435-637-6799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 N FAIRGROUNDS RD",
            "address_2": "SUITE #3",
            "city": "PRICE",
            "state": "UT",
            "postal_code": "845014203",
            "telephone_number": "435-637-6797",
            "fax_number": "435-637-6799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENNIS A BLACKBURN, D.P.M.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-05",
        "last_updated": "2007-12-05",
        "status": "A",
        "authorized_official_last_name": "BLACKBURN",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "435-637-6797",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "UT",
            "license": "103173-0501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Podiatrist in Price, UT
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• Podiatrist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.