Michael G Blackburn (NPI# 1063429652, PAC ID# 8820061419) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1063429652 |
| PAC ID by PECOS | 8820061419 |
| Professional Enrollment ID | I20040812001213 |
| Full Name | Michael G Blackburn |
| Address |
201 15th Ave Sw Suite C Puyallup WA 98371-7495 |
| Gender | M |
| Credential | MD |
| Medical School | RUSH MEDICAL COLLEGE OF RUSH UNIVERSITY |
| Graduation Year | 1980 |
| Primary Specialty | INTERNAL MEDICINE |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 500129 | TACOMA GENERAL ALLENMORE HOSPITAL |
| 500079 | MULTICARE GOOD SAMARITAN HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 201 15th Ave Sw, Suite C, Puyallup, WA 98371-7495 |
| Street Address |
201 15TH AVE SW SUITE C |
| City | PUYALLUP |
| State | WA |
| Zip | 98371-7495 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jon H Rogers | Chiropractic | 1625 Meridian Ave E, Edgewood, WA 98371-1013 | |
| Hugh J Gorey Jr. | Podiatry | 2121 Meridian Ave E, Suite 11, Edgewood, WA 98371-1030 | |
| Ronald O Acosta | Chiropractic | Ronald O. Acosta, D.c. Pllc | 2809 Meridian Ave E, Edgewood, WA 98371-2108 |
| Rodney M Meeker | Chiropractic | Ronald O. Acosta, D.c. Pllc | 2809 Meridian Ave E, Edgewood, WA 98371-2108 |
| Dale Hansen | Chiropractic | Ronald O. Acosta, D.c. Pllc | 2809 Meridian Ave E, Edgewood, WA 98371-2108 |
| Daniel D Sillito | Chiropractic | Sillito Chiropractic Center, Ps | 2908 Meridian Ave E, Suite 101, Edgewood, WA 98371-2191 |
| Derrol M Sillito | Chiropractic | Sillito Chiropractic Center, Ps | 2908 Meridian Ave E, Suite 101, Edgewood, WA 98371-2191 |
| Conrad J Thiede | Chiropractic | 2908 Meridian Ave E, Suite 103, Edgewood, WA 98371-2195 | |
| Ronald Frank Conti | Chiropractic | 3217 Meridian Ave E, Edgewood, WA 98371-2613 | |
| Gary D Linton | Optometry | Puyallup Vision Center Ps | 113 W Pioneer, Puyallup, WA 98371-5373 |
| Find all physicians in zip 98371 | |||
| City | PUYALLUP |
| Zip Code | 98371 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | PUYALLUP + INTERNAL MEDICINE |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.