Individual
DR. JORDAN C. A. BLACKWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6 HEARTS WAY, QUEENSBURY, NY 12804-5925
(518) 792-1233
Mailing address
100 PARK STREET, GLENS FALLS HOSPITAL - CREDENTIALING, GLENS FALLS, NY 12801
(518) 926-5924
(518) 926-6983
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
256272
NY
207RC0000X
Cardiovascular Disease Physician
Primary
256272
NY
Other
Enumeration date
04/11/2010
Last updated
02/21/2022
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