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:
Health care specialties
| Specialty | Code | License # | 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 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649221177 | NPPES |
| Oklahoma | MEDICAID | 100188740C |
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