Individual
DR. KIMATHI SIPHO RICARDO BLACKWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
890 SECOND STREET, SUITE 201, MACON, GA 31201-6863
(478) 745-4322
(478) 750-8789
Mailing address
595 HURRICANE SHOALS RD NW STE 100, LAWRENCEVILLE, GA 30046-8762
(404) 645-7150
(770) 995-0776
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
063834
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
546478200BB
—
GA
05
—
546478200C
—
GA
Enumeration date
06/20/2007
Last updated
06/21/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us