Blackwell, Kendall Leon

Blackwell, Kendall Leon is an individual health care provider with primary practice located at 1704 Glendale Dr Sw Suite A, Wilson NC 27893-4678. He recently has 3 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, Podiatric Medicine & Surgery Service Providers / Foot Surgery, Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine. Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine is his primary health care specialty. Blackwell, Kendall Leon can be contacted via phone (252) 237-0138.

Contact Information

Primary practice address
1704 Glendale Dr Sw Suite A Wilson NC 27893-4678
Phone: (252) 237-0138
Fax: (252) 237-7903
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 238 North Carolina
Podiatric Medicine & Surgery Service Providers / Foot Surgery 213ES0131X 238 North Carolina
Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine 213EP1101X 238 North Carolina

Profile Details

NPI number 1366483638
LBN Legal business name Blackwell, Kendall Leon
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2006
Last updated Aug 9th, 2022 - about 2 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 1366483638 NPPES
North Carolina MEDICAID 79-0804G

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