Individual
GEORGIA BLACKWOOD KUBIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
375 CHIPETA WAY, UNIVERSITY OF UTAH FAMILY MEDICINE RESIDENCY, SALT LAKE CITY, UT 84108-1260
(801) 587-3411
Mailing address
2232 HAVERSHAM CLOSE, VIRGINIA BEACH, VA 23454-1151
(757) 630-4046
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
8406695-1205
UT
Other
Enumeration date
04/19/2011
Last updated
08/20/2014
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