Blackwell, Vicki M

Blackwell, Vicki M is an individual health care provider with primary practice located at 2010 Patton Chapel Rd Ste 200 , Vestavia Hills AL 35216-5784. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Blackwell, Vicki M can be contacted via phone (205) 910-7599.

Contact Information

Primary practice address
2010 Patton Chapel Rd Ste 200 Vestavia Hills AL 35216-5784
Phone: (205) 910-7599
Fax: (205) 208-9001
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA-104 Alabama

Profile Details

NPI number 1043235963
LBN Legal business name Blackwell, Vicki M
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2006
Last updated Aug 24th, 2023 - 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 1043235963 NPPES
Alabama MEDICAID 051553463
Alabama Other P00010094
Alabama Other 51514981BUR

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