Mark R Blackwood, MD
Individual provider Active NPI Family Medicine Physician · Durham, NH
NPI 1376599217 · NPPES record last updated Feb 17, 2014
Key facts
- NPI
- 1376599217
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 8732 (NH)
- Practice address
- 36 Madbury Rd
Durham, NH 03824-2021 - Phone
- (603) 868-5080
- Fax
- (603) 868-7440
- NPI assigned
- May 25, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050526000242 | NH | Practitioner - Family Practice | 8527000892 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wentworth Douglass Physician Corporation | Current |
Accepting new patients | |
| Wentworth Douglass Physician Corporation | Family Medicine | Current |
Accepting new patients |
| Wentworth Douglass Hospital | Current | Accepting new patients |
Locations
19 Levesque Dr
Ste 2
Eliot, ME 03903
Phone (207) 451-9600
31 Colcord St
South Berwick, ME 03908
Phone (207) 384-4022
8 Century Pines Dr
Ste 2
Barrington, NH 03825
Phone (603) 664-2135
789 Central Ave
Dover, NH 03820
Phone (603) 740-2832
750 Central Ave
Ste O
Dover, NH 03820
Phone (603) 431-5205
10 Members Way
Ste 200
Dover, NH 03820
Phone (603) 609-6930
750 Central Ave
Ste Q
Dover, NH 03820
Phone (603) 742-6030
36 Madbury Rd
Durham, NH 03824
Phone (603) 659-0901
65 Calef Hwy
Ste 200
Lee, NH 03861
Phone (603) 868-3300
73 Corporate Dr
Bldg B
Portsmouth, NH 03801
Phone (603) 610-8058
67 Corporate Dr
Fl 3
Portsmouth, NH 03801
Phone (603) 610-8050
150 Marketplace Blvd
Unit 9
Rochester, NH 03867
Phone (603) 516-4212
Interoperability endpoints
- blackwood.mark.wdh@direct.partners.masshiway.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 8732 | NH | Yes |
Addresses
Primary practice location
36 Madbury Rd
Durham, NH 03824-2021
Mailing address
789 Central Ave
Dover, NH 03820-2526
Phone (603) 868-5080
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3075907 | Medicaid | NH | |
| 1376599217 | Medicaid | ME |
Other providers in Durham, NH
- Sally Ann Baker
- Theresa D Bakker
- Hannah Lynn Berg
- Better Gut Better Health, LLC
- Better Self Better Life, P.L.L.C.
- Rebecca Blake
- Erika Louise Blocher
- Bragdon Dugas & Rutter PC
- Bruce R Bragdon
- Katharina Rae Brandt
All providers in Durham, NH · Family Medicine Physician in New Hampshire
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 17, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.