Individual
REID B BLACKWELDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
102 E RAVINE RD, KINGSPORT, TN 37660
(423) 245-9600
(423) 245-9634
Mailing address
PO BOX 699, MOUNTAIN HOME, TN 37684-0699
(423) 245-9600
(423) 245-9634
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23792
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q011980
—
TN
Enumeration date
03/23/2006
Last updated
01/16/2024
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