Blackledge, Camille Denise

Blackledge, Camille Denise is an individual health care provider with primary practice located at 2405 W Missouri Ave , Midland TX 79701-6800. She recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as her primary health care specialty. Blackledge, Camille Denise can be contacted via phone (432) 697-1061.

Contact Information

Primary practice address
2405 W Missouri Ave Midland TX 79701-6800
Phone: (432) 697-1061
Fax: (432) 697-7089
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 33297 Alabama
Allopathic & Osteopathic Physicians / Surgery 208600000X Q5158 Texas

Profile Details

NPI number 1427291533
LBN Legal business name Blackledge, Camille Denise
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 20th, 2009
Last updated Jan 6th, 2023 - about 2 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 1427291533 NPPES
Texas MEDICAID 363823103

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