Billy R Blackwell, M. D.
Individual provider Active NPI Contractor · Florence, SC
NPI 1689907784 · NPPES record last updated Sep 8, 2009
Key facts
- NPI
- 1689907784
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- 4914 (SC)
- Practice address
- 907 Santee Dr
Florence, SC 29501-5737 - Phone
- (843) 669-0423
- NPI assigned
- Sep 8, 2009
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4914 | SC | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor |
171W00000X | 4914 | SC | Yes |
Addresses
Primary practice location
907 Santee Dr
Florence, SC 29501-5737
Mailing address
907 Santee Dr
Florence, SC 29501-5737
Phone (843) 669-0423
Other providers in Florence, SC
- Craig Black
- Lauren Black
- Neicole Dutton Black
- Sharon Lajoyce Black
- Timothy Blackner
- Joyce Blackwell
- Christie Ellen Blair
- Alan M Blaker
- Brian David Blaker
- Shirlene Blanton
All providers in Florence, SC · Contractor in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 8, 2009. 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.