Genevieve J.t. Blackwelder, M.D.

NPI #1770791717 in Tyler, Texas

Provider Information

NPI Number: 1770791717
Entity Type: Individual
Name: Genevieve J.t. Blackwelder, M.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Pediatrics
Credential: M.D.
Enumeration Date: May 21, 2007
Last Updated: Oct 23, 2009

Practice Location

Address: 6526 ASHMORE LN
City: Tyler
State: Texas
ZIP Code: 75703-5896
Phone: (972) 489-3005

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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