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Individual

RALPH ALLEN BLACKWOOD JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3 RIVERSIDE CIRCLE, ROANOKE, VA 24016
(540) 224-5170
(540) 772-8219
Mailing address
3 RIVERSIDE CIRCLE, ROANOKE, VA 24016
(540) 224-5170
(540) 983-8229

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101058629
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1518943026
VA
05
5819253
VA
05
5836549
VA
05
5863830
VA
05
6728871
VA
Enumeration date
12/16/2005
Last updated
10/13/2021
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