Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Timothy Blackstad, DO

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1396523643

Timothy Blackstad, DO is a Student in an Organized Health Care Education/Training Program in Tulsa, Oklahoma. Practices as a sole proprietor and works from 2 locations. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

4502 E 41st St
Tulsa, OK 74135-2536
Phone: (918) 579-2367
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1111 W 17th St, Tulsa, OK 74107-1886 — (918) 582-1972

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1396523643
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorYes
NPI enumeratedSeptember 18, 2023
Last updated in NPPESApril 2, 2025
Certification dateApril 2, 2025
Mailing address4308 W Kent St, Broken Arrow, OK 74012-9419

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