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Kory Blackwell
NPI 1255751525 · on the registry since 2014
Practice
- Address
- 5192 Old Highway 11 Ste 2
Hattiesburg, MS 39402 - Phone
- (601) 268-0929
- Fax
- (601) 261-0508
- Organisation at this address
- Hattiesburg Clinic Pa
Oak Grove Family ClinicInferred from a shared address, not stated in the registry. - Clinicians at this address
- 7
Registry record
- Primary taxonomy
- Family Medicine Physician
207Q00000X
- Licence states on file
- MS
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2021-01-07
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Mississippi