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TIMOTHY BLACKSTAD DO
NPI 1396523643
Student in an Organized Health Care Education/Training Program in Tulsa, OK

Active since September 18, 2023
4502 E 41ST ST, TULSA, OK 74135(918) 579-2367 Get Directions Write a Review

NPPES record last updated: April 2, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Timothy Blackstad Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TIMOTHY BLACKSTAD DO (NPI 1396523643) is an individual student in an organized health care education/training program in Tulsa, Oklahoma and active in the NPI registry since September 2023. He maintains a secondary practice location in Tulsa.

NPPES Registry Identity

NPI1396523643
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameTIMOTHY BLACKSTADCredential: DO
Location Address4502 E 41ST STTulsa, OK 74135-2536
Mailing Address4308 W Kent StBroken Arrow, OK 74012-9419 · (918) 644-9799
Phone(918) 579-2367
Sole ProprietorYes
Enumeration DateSeptember 18, 2023
Last NPPES UpdateApril 2, 2025
NPPES CertifiedApril 2, 2025
✔ NPI 1396523643 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
4502 E 41ST ST, Tulsa, OK 74135
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Secondary Practice Location 1

Location 11111 W 17th StTulsa, OK 74107-1886 · Phone (918) 582-1972

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. MICHAEL DANIEL FIGUEIREDO MD
Emergency Medicine
4502 E 41ST ST
TULSA, OK 74135
Tulsa County (918) 619-4400
PETER MADDEN MD
Internal Medicine
4502 E 41ST ST
TULSA, OK 74135
Tulsa County (918) 619-4400
AMNA OBAID
Student in an Organized Health Care Education/Training Program
4502 E 41ST ST
TULSA, OK 74135
Tulsa County (918) 619-4400
LAMAURI FRANKLIN
Student in an Organized Health Care Education/Training Program
4502 E 41ST ST
TULSA, OK 74135
Tulsa County (918) 660-3842
SAI ATLURI MD
Internal Medicine
4502 E 41ST ST
TULSA, OK 74135
Tulsa County (918) 619-4888
HAIDEN REECE PETERSON
Student in an Organized Health Care Education/Training Program
4502 E 41ST ST
TULSA, OK 74135
Tulsa County (918) 660-3842
RILEY SHULER POLK MD
Emergency Medicine
4502 E 41ST ST
TULSA, OK 74135
Tulsa County (918) 579-2367
DR. STEPHEN HODGES THOMAS MD
Emergency Medicine
4502 E 41ST ST
TULSA, OK 74135
Tulsa County (918) 660-3831

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Timothy Blackstad's NPI number?

The NPI number for Timothy Blackstad is 1396523643. It was assigned to this individual provider in the NPPES registry on September 18, 2023.

Where is Timothy Blackstad located?

Timothy Blackstad practices at 4502 E 41st St, Tulsa, OK 74135. The listed phone number is (918) 579-2367.

What is Timothy Blackstad's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Timothy Blackstad was last updated on April 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.