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Individual

KEVIN MICHAEL BLACKWOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
7777 HENNESSY BLVD STE 301, BATON ROUGE, LA 70808-0319
(225) 214-6438
Mailing address
7777 HENNESSY BLVD STE 301, BATON ROUGE, LA 70808-0319
(225) 214-6438

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
301615
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2149733
LA
Enumeration date
03/18/2011
Last updated
10/17/2017
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