Organization
BLACKWELL'S FAMILY MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISOTPHER WILLIAM BLACKWELL FNP (OWNER, PROVIDER)
(601) 377-1975
Entity
Organization
Contact information
Practice address
107 BALL AVE, TYLERTOWN, MS 39667-2101
(601) 303-8264
Mailing address
171 PIGOTT EASTERLING RD, TYLERTOWN, MS 39667-7222
(601) 303-8264
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
06/27/2019
Last updated
03/15/2021
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