Individual
DR. DOUGLAS HUNT BLACKLEDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
950 MATTHEW DR, WAYNESBORO, MS 39367-2567
(601) 735-7246
(601) 735-7245
Mailing address
103 BRECKENRIDGE DR, WAYNESBORO, MS 39367-3134
(601) 671-1155
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
23160
MS
207L00000X
Anesthesiology Physician
T-2288
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03504265
—
MS
Enumeration date
07/12/2010
Last updated
03/04/2020
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