Timothy John Blackowikak, LPN is a
Licensed Practical Nurse based in Dundas, Minnesota. Timothy John Blackowikak is licensed to practice in Minnesota (license number L36999-0) and his current practice location is
212 Forest Ave N, Dundas, Minnesota. He can be reached at his office (for appointments etc.) via phone at
(612) 423-5639.
NPI number for Timothy John Blackowikak is 1750701272 and his current mailing address is 212 Forest Ave N, Dundas, Minnesota. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1750701272.
Provider's Profile
| Full Name | Timothy John Blackowikak |
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| Gender | Male |
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| Speciality | Licensed Practical Nurse |
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| Location | 212 Forest Ave N, Dundas, Minnesota |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1750701272
- Provider Enumeration Date: 04/23/2014
- Last Update Date: 04/23/2014
Medical Identifiers
Medical identifiers for Timothy John Blackowikak such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1750701272 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 164W00000X | Licensed Practical Nurse | L36999-0 (Minnesota) | Primary |
| 164X00000X | Licensed Vocational Nurse | L36999-0 (Minnesota) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Timothy John Blackowikak is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Timothy John Blackowikak, LPN
212 Forest Ave N,
Dundas, MN 55019-3941
Ph: (612) 423-5639 | Timothy John Blackowikak, LPN
212 Forest Ave N,
Dundas, MN 55019-3941
Ph: (612) 423-5639 |
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