Individual
KAREN DYER BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
310 N 7 HILLS RD, O FALLON, IL 62269-4111
(618) 624-6181
(618) 624-7172
Mailing address
4500 MEMORIAL DRIVE, MEMORIAL HOSPITAL MEDICAL AFFAIRS, BELLEVILLE, IL 62226
(618) 257-4644
(618) 257-6946
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085005182
IL
Other
Enumeration date
12/16/2009
Last updated
02/22/2016
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