Individual
DR. MICHAEL ADAMS BLACKMORE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
20 5TH ST NW, MASON CITY, IA 50401-3232
(641) 422-9000
(641) 422-9088
Mailing address
20 5TH ST NW, MASON CITY, IA 50401-3232
(641) 422-9000
(641) 422-9088
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
27073
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8106872
—
IA
Enumeration date
01/17/2006
Last updated
07/08/2007
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