Individual
DR. BERT ERIC BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4538 S HARVARD AVE, TULSA, OK 74135-2906
(918) 712-3377
(918) 712-3373
Mailing address
1145 S UTICA AVE STE 110, TULSA, OK 74104-4013
(918) 579-6863
(918) 579-6869
Taxonomy
Speciality
Code
Description
License number
State
207PE0005X
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
Primary
3343
OK
207Q00000X
Family Medicine Physician
3343
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100188740C
—
OK
Enumeration date
05/12/2006
Last updated
11/30/2017
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