Blackwell, Bert Eric

Blackwell, Bert Eric is an individual health care provider with primary practice located at 4538 S Harvard Ave , Tulsa OK 74135-2906. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine. Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine is his primary health care specialty. Blackwell, Bert Eric can be contacted via phone (918) 712-3377.

Contact Information

Primary practice address
4538 S Harvard Ave Tulsa OK 74135-2906
Phone: (918) 712-3377
Fax: (918) 712-3373
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 3343 Oklahoma
Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine 207PE0005X 3343 Oklahoma

Profile Details

NPI number 1649221177
LBN Legal business name Blackwell, Bert Eric
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2006
Last updated Nov 30th, 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 1649221177 NPPES
Oklahoma MEDICAID 100188740C

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