Eric Blackwell
Individual provider Active NPI Driver · South Hill, VA
NPI 1316477136 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1316477136
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- License
- T69517889 (VA)
- Practice address
- 248 Circle Dr
South Hill, VA 23970 - Phone
- (434) 247-1047
- NPI assigned
- Jun 14, 2017
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T69517889 | VA | MD | Driver |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | T69517889 | VA | Yes |
Addresses
Primary practice location
248 Circle Dr
South Hill, VA 23970
Mailing address
248 Circle Dr
South Hill, VA 23970-3305
Phone (434) 247-1047
Other providers in South Hill, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.