| Dr Jeffrey Blackwell, MD, PHD | |
|
12180 Alder St, Meadowview, VA 24361 | |
| (276) 695-0205 | |
| Not Available |
| Full Name | Dr Jeffrey Blackwell |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 6 Years |
| Location | 12180 Alder St, Meadowview, Virginia |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013544774 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0101278580 (Virginia) | Primary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Smyth County Community Hospital | Marion, VA | Hospital |
| Johnston Memorial Hospital | Abingdon, VA | Hospital |
| Russell County Hospital | Lebanon, VA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Smyth County Community Hospital | 0446168496 | 3 |
| Entity Name | Smyth County Community Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174529242 PECOS PAC ID: 0446168496 Enrollment ID: O20031229000522 |
| Entity Name | Blue Ridge Medical Management Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1326159567 PECOS PAC ID: 9739099441 Enrollment ID: O20040715001336 |
| Entity Name | Abingdon Physician Partners |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306944350 PECOS PAC ID: 5991705667 Enrollment ID: O20070102000365 |
| Entity Name | Wellmont Medical Associates Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174808216 PECOS PAC ID: 8123291739 Enrollment ID: O20120627000467 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jeffrey Blackwell, MD, PHD 1021 W Oakland Ave Ste 310, Johnson City, TN 37604-2192 Ph: (423) 952-2111 | Dr Jeffrey Blackwell, MD, PHD 12180 Alder St, Meadowview, VA 24361 Ph: (276) 695-0205 |