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Dr. William A Blackman

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NPI Number Detailed Information

Provider Information:

Name: Dr. William A Blackman
Gender: M
Provider License Number If Given: 101036652

NPI Information:

NPI: 1528067105
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 7/18/2005

Last Update Date: 10/28/2011

Provider Business Mailing Address:

Address: 1901 THOMSON DR
Lynchburg, VA 24501
Phone Number: 4349473908
Fax Number: 4349475948

Provider Business Practice Location Address:

Address: 1901 THOMSON DR
Lynchburg, VA 24501
Phone Number: 4349473908
Fax Number: 4349475948

Provider Taxonomy:

Primary: 207R00000X
Secondary (if any):
State: VA

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