Individual
BRIAN K BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
25892 N. JAMES MADISON HWY, NEW CANTON, VA 23123-0220
(434) 581-3271
(434) 581-1105
Mailing address
PO BOX 220, NEW CANTON, VA 23123-0220
(434) 581-3271
(434) 581-1105
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101046735
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110244531
RAILROAD MEDICARE
VA
Enumeration date
01/06/2006
Last updated
10/02/2023
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