Blackwell, Darrell Kevin

Blackwell, Darrell Kevin is an individual health care provider with primary practice located at 1490 Park Ave Nw Suite 5, Norton VA 24273-1631. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sports Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Blackwell, Darrell Kevin can be contacted via phone (276) 439-1440.

Contact Information

Primary practice address
1490 Park Ave Nw Suite 5 Norton VA 24273-1631
Phone: (276) 439-1440
Fax: (276) 439-1441
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 0102050073 Virginia
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 0102050073 Virginia

Profile Details

NPI number 1710079819
LBN Legal business name Blackwell, Darrell Kevin
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 28th, 2006
Last updated Jan 27th, 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 1710079819 NPPES
Virginia MEDICAID 1710079819

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