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General NPI Number Information
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NPI Number | 1265389472
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Entity Type | Organization
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Legal Business Name | BLACKMER PODIATRY
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Dates
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Enumeration Date | 03/16/2026
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Last Update Date | 03/16/2026
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Provider Practice Location Address
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Address Line | 3080 E GENTRY WAY STE 201
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City | MERIDIAN
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State | ID
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Zip | 83642-3013
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Country | US
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Telephone | 208-605-3662
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Fax |
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Provider Business Mailing Address
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Address Line | 3080 E GENTRY WAY STE 201
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City | MERIDIAN
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State | ID
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Zip | 83642-3013
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING DIRECTOR
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Name | JULIE READ
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Credential |
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Telephone | 208-605-3662
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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