Blackwell, Gerald G

Blackwell, Gerald G is an individual health care provider with primary practice located at 2050 Meadowview Parkway , Kingsport TN 37660-7332. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Blackwell, Gerald G can be contacted via phone (423) 230-5000.

Contact Information

Primary practice address
2050 Meadowview Parkway Kingsport TN 37660-7332
Phone: (423) 230-5000
Fax: (423) 230-5097
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 27170 Tennessee

Profile Details

NPI number 1689600587
LBN Legal business name Blackwell, Gerald G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2006
Last updated Dec 3rd, 2014 - about 10 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 1689600587 NPPES
Virginia MEDICAID 5836361
Virginia MEDICAID 060034463
Virginia Other 621112685
Virginia MEDICAID 3094989

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