Individual
LISA RENEE BLACKWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
132 VILLAGE CENTER RD, HARLAN, KY 40831
(606) 573-7771
(606) 573-2809
Mailing address
PO BOX 40, WHITESBURG, KY 41858-0040
(606) 633-4823
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
261223
NY
207V00000X
Obstetrics & Gynecology Physician
Primary
52468
KY
Other
Enumeration date
04/22/2011
Last updated
10/05/2023
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