| Keith William Blackman, MD | |
|
11312 Jefferson Hwy, River Ridge, LA 70123-1709 | |
| (504) 464-0032 | |
| (504) 466-3440 |
| Full Name | Keith William Blackman |
|---|---|
| Gender | Male |
| Speciality | Preventive Medicine - Public Health & General Preventive Medicine |
| Location | 11312 Jefferson Hwy, River Ridge, Louisiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477532885 | NPI | - | NPPES |
| 1679941 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2083P0901X | Preventive Medicine - Public Health & General Preventive Medicine | 10367R (Louisiana) | Primary |
| Entity Name | Emergency Staffing Solutions Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1477590974 PECOS PAC ID: 9830001650 Enrollment ID: O20050610000177 |
| Entity Name | Rapid Urgent Care Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285970780 PECOS PAC ID: 0840437174 Enrollment ID: O20130506000203 |
| Entity Name | Ess Hospitalist Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881967305 PECOS PAC ID: 6103085295 Enrollment ID: O20130515000072 |
| Entity Name | Concord Medical Group Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1083630610 PECOS PAC ID: 0446296818 Enrollment ID: O20140930001176 |
| Entity Name | Crowley Emergency Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508275538 PECOS PAC ID: 1456572965 Enrollment ID: O20141027002233 |
| Entity Name | Oakdale Ess Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1750785119 PECOS PAC ID: 7517289713 Enrollment ID: O20141125000402 |
| Mailing Address | Practice Location Address |
|---|---|
| Keith William Blackman, MD Po Box 19988, New Orleans, LA 70179-0988 Ph: (504) 464-0032 | Keith William Blackman, MD 11312 Jefferson Hwy, River Ridge, LA 70123-1709 Ph: (504) 464-0032 |