Dr TIMOTHY R BLACK is a male medical professional, specializing in Podiatry. He graduated in 2000 from California College Podiatric Medicine.
1628 ELK CREEK DR
IDAHO FALLS
ID
834048349
Tel:
| Npi | 1578753091 |
| Pac Id | 0244329738 |
| Professional Enrollment Id | I20071207000164 |
| Last Name | BLACK |
| First Name | TIMOTHY |
| Middle Name | R |
| Suffix | |
| Gender | M |
| Credential | |
| Medical School Name | CALIFORNIA COLLEGE PODIATRIC MEDICINE |
| Graduation Year | 2000 |
| Primary Specialty | PODIATRY |
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| Line 1 Street Address | 1628 ELK CREEK DR |
| Line 2 Street Address | |
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| City | IDAHO FALLS |
| State | ID |
| Zip Code | 834048349 |
| Phone Number | |
| Hospital Affiliation Ccn 1 | 130065 |
| Hospital Affiliation Lbn 1 | MOUNTAIN VIEW HOSPITAL |
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| Professional Accepts Medicare Assignment | Y |
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