Individual
DR. DON BLACKWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
803 1ST ST, CLEVELAND, MS 38732-2309
(662) 843-2721
Mailing address
803 1ST ST, CLEVELAND, MS 38732-2309
(662) 843-2721
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
06159
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00115094
—
MS
01
—
P00233159
MEDICARE RAILROAD
MS
Enumeration date
03/17/2006
Last updated
10/25/2011
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