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BRIAN K BLACKWELL MD

>> Internal Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1447238738

Individual Registrant:
 BRIAN K BLACKWELL MD
Gender: M
Not Sole Proprietor

Location and contact information for practice:
25892 N. JAMES MADISON HWY  NEW CANTON, VA 23123-0220 US
Tel: 434-581-3271  Fax: 434-581-1105

Contact information for business:
PO BOX 220  NEW CANTON, VA 23123-0220 US
Tel: 434-581-3271  Fax: 434-581-1105

Registration Information:
NPI: 1447238738
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207R00000XAllopathic & Osteopathic Physicians
Internal Medicine
VA0101046735

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
015851C46VA08
RAILROAD MEDICARE110244531VA01
F1685802




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