Blackwell's Family Medicine LLC
NPI #1366003436 in Tylertown, Mississippi
Provider Information
- NPI Number
- 1366003436
- Entity Type
- Organization
- Organization Name
- Blackwell's Family Medicine LLC
- Primary Specialty
- Clinic/Center - Primary Care
- Enumeration Date
- Jun 27, 2019
- Last Updated
- Mar 15, 2021
Practice Location
- Address
- 107 BALL AVE
- City
- Tylertown
- State
- Mississippi
- ZIP Code
- 39667-2101
- Phone
- (601) 303-8264
Authorized Official
- Name
- MR. CHRISOTPHER WILLIAM BLACKWELL, FNP
- Title
- OWNER, PROVIDER
- Phone
- (601) 377-1975
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Primary Care — Primary Care |
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