Individual
JOSEPH W BLACKSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
11335
MS
207R00000X
Internal Medicine Physician
Primary
MD 11335
MS
209800000X
Legal Medicine (M.D./D.O.) Physician
MD 11335
MS
Other
Enumeration date
08/29/2006
Last updated
09/11/2007
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