Blackston, Barry C

Blackston, Barry C is an sole proprietor health care provider with primary practice located at 8 Memorial Medical Ct Ste 4, Greenville SC 29605-4400. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Blackston, Barry C can be contacted via phone (864) 242-5678.

Contact Information

Primary practice address
8 Memorial Medical Ct Ste 4 Greenville SC 29605-4400
Fax: (864) 242-5679
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 16698 South Carolina

Profile Details

NPI number 1316948185
LBN Legal business name Blackston, Barry C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 3rd, 2005
Last updated Sep 14th, 2017 - about 7 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 1316948185 NPPES
South Carolina MEDICAID GP3048

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