Blackstone, Connie J
Blackstone, Connie J is an individual health care provider with primary practice located at 404 Se Main Street Suite 300, Simpsonville SC 29681-0279. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Blackstone, Connie J can be contacted via phone (864) 963-8002.Contact Information
Primary practice address
404 Se Main Street Suite 300
Simpsonville SC 29681-0279
Phone: (864) 963-8002
Fax: (864) 963-2742
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 15537 | South Carolina |
Profile Details
| NPI number | 1497766588 |
|---|---|
| LBN Legal business name | Blackstone, Connie J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 11th, 2006 |
| Last updated | Feb 19th, 2015 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497766588 | NPPES |
| South Carolina | MEDICAID | 155370 | |
| South Carolina | Other | 576007863095 |
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