Blackman, Keith William

Blackman, Keith William is an individual health care provider with primary practice located at 11312 Jefferson Hwy , River Ridge LA 70123-1709. He recently has only one registered license in Allopathic & Osteopathic Physicians / Public Health & General Preventive Medicine, which is considered as his primary health care specialty. Blackman, Keith William can be contacted via phone (504) 464-0032.

Contact Information

Primary practice address
11312 Jefferson Hwy River Ridge LA 70123-1709
Phone: (504) 464-0032
Fax: (504) 466-3440
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Public Health & General Preventive Medicine 2083P0901X 10367R Louisiana

Profile Details

NPI number 1477532885
LBN Legal business name Blackman, Keith William
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 13th, 2006
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477532885 NPPES
Louisiana MEDICAID 1679941

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