Individual
MAGGIE BLACKWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4451 COUNTRY CLUB RD STE B, STATESBORO, GA 30458-9255
(912) 871-5437
Mailing address
4451 COUNTRY CLUB RD STE B, STATESBORO, GA 30458-9255
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
31288
WV
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2019
Last updated
07/14/2023
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