Individual
DR. MARK EDWARD BLACKWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 FIRST ST, CLEVELAND, MS 38732
(662) 843-0880
(662) 843-0889
Mailing address
801 1ST ST, CLEVELAND, MS 38732-2398
(662) 843-0880
(662) 843-0889
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
13157
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00114916
—
MS
Enumeration date
10/04/2006
Last updated
02/08/2021
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