Blackall, Douglas P

Blackall, Douglas P is an individual health care provider with primary practice located at 4805 Ne Glisan St , Portland OR 97213-2933. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Blood Banking & Transfusion Medicine, Allopathic & Osteopathic Physicians / Clinical Pathology/Laboratory Medicine, Allopathic & Osteopathic Physicians / Clinical Pathology. Allopathic & Osteopathic Physicians / Clinical Pathology is his primary health care specialty. Blackall, Douglas P can be contacted via phone (503) 215-6096.

Contact Information

Primary practice address
4805 Ne Glisan St Portland OR 97213-2933
Phone: (503) 215-6096
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Blood Banking & Transfusion Medicine 207ZB0001X MD202871 Oregon
Allopathic & Osteopathic Physicians / Blood Banking & Transfusion Medicine 207ZB0001X C-7459 Arkansas
Allopathic & Osteopathic Physicians / Clinical Pathology/Laboratory Medicine 207ZP0105X C-7459 Arkansas
Allopathic & Osteopathic Physicians / Clinical Pathology 207ZC0006X MD202871 Oregon

Profile Details

NPI number 1891885380
LBN Legal business name Blackall, Douglas P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 13th, 2006
Last updated Jan 15th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891885380 NPPES
Arkansas MEDICAID 152157001

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