Blackwell, Dustin Patrick

Blackwell, Dustin Patrick is an individual health care provider with primary practice located at 700 Willow St Ste 203 , Vincennes IN 47591-1029. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Obstetrics. Allopathic & Osteopathic Physicians / Obstetrics is his primary health care specialty. Blackwell, Dustin Patrick can be contacted via phone (812) 882-1000.

Contact Information

Primary practice address
700 Willow St Ste 203 Vincennes IN 47591-1029
Phone: (812) 882-1000
Fax: (812) 882-1004
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 02005674B Indiana
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Obstetrics 207VX0000X 02005674A Indiana

Profile Details

NPI number 1841682374
LBN Legal business name Blackwell, Dustin Patrick
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 20th, 2015
Last updated Mar 25th, 2020 - about 6 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 1841682374 NPPES
Indiana MEDICAID 300028633

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