Individual
BLAIR GREENWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
587 HWY 365, MAYFLOWER, AR 72106-9570
(501) 470-7413
(501) 470-7415
Mailing address
PO BOX 925, MAYFLOWER, AR 72106-0925
(501) 470-7413
(501) 470-7415
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
E4447
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
043852
MEDICARE RURAL HEALTH
AR
05
—
158193001
—
AR
Enumeration date
06/28/2006
Last updated
12/10/2013
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