Individual
DR. BARRY C BLACKSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8 MEMORIAL MEDICAL CT, STE 4, GREENVILLE, SC 29605-4400
(864) 242-5678
(864) 242-5679
Mailing address
8 MEMORIAL MEDICAL CT, STE 4, GREENVILLE, SC 29605-4400
(864) 242-5678
(864) 242-5679
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
16698
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP3048
—
SC
Enumeration date
08/03/2005
Last updated
09/14/2017
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