Individual
DR. JAMES WAID BLACKSTONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
209 W SPRING ST STE 302, SYLACAUGA, AL 35150-2976
(205) 723-0081
(250) 723-0837
Mailing address
209 W SPRING ST STE 302, SYLACAUGA, AL 35150-2976
(205) 723-0081
(205) 723-0837
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
24790
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009932211
—
AL
01
—
051001264
BLUE CROSS BLUE SHIELD AL
AL
01
—
202682193
TRICARE
AL
01
—
7541689
AETNA
AL
Enumeration date
01/25/2006
Last updated
11/13/2024
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