Individual
BRYAN CHRISTOPHER BLACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5409 AVENUE O STE 121, FORT MADISON, IA 52627-9673
(319) 372-5437
(319) 376-2719
Mailing address
1501 INDIAN SCHOOL RD NE APT D105, ALBUQUERQUE, NM 87102-1641
(505) 377-2773
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD-47016
IA
Other
Enumeration date
03/31/2017
Last updated
12/20/2024
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