Individual
DR. KELLIE MIRANDA SMITH BLACKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
117 COOK ST, ABINGDON, VA 24210-3203
(276) 619-5052
(276) 619-5115
Mailing address
PO BOX 3889, JOHNSON CITY, TN 37602-3889
(423) 433-6625
(423) 723-2669
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0102203141
VA
207Q00000X
Family Medicine Physician
5527
TN
Other
Enumeration date
06/19/2009
Last updated
01/11/2024
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