Individual
ROBERT BLACKSTONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2211 LOMAS BLVD NE, ALBUQUERQUE, NM 87106-2719
(505) 272-4107
Mailing address
2211 LOMAS BLVD NE, ALBUQUERQUE, NM 87106-2719
(505) 272-6444
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA2017-0078
NM
Other
Enumeration date
09/24/2017
Last updated
12/12/2017
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