Dr. Kendall Leon Blackwell
Foot Surgery
1704 Glendale Dr Sw Suite A
Wilson
, North Carolina 27893-4678
Dr. Kendall Leon Blackwell
Foot Surgery
1704 Glendale Dr Sw Suite A
Wilson
, North Carolina 27893-4678
(252) 991-3736
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About
Features
Specialties
- Foot Surgery
Languages spoken
- English
Location
First Address
- Dr. Kendall Leon Blackwell
- 3205 Westshire Drive
- Wilson, NC
- Zip : 27896
- Phone : (252) 991-3736
Second Address
- Dr. Kendall Leon Blackwell
- 1704 Glendale Dr Sw Suite A
- Wilson, NC
- Zip : 27893-4678
- Fax : (252) 237-7903
- Phone : (252) 237-0138
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 213ES0131X | Foot Surgery | 238 | NC |
National Provider Identifier
| NPI | 1366483638 |
|---|---|
| Provider Name | Dr. Kendall Leon Blackwell |
| First Address | Wilson, NC 27896 |
| Second Address | Wilson, NC 27893-4678 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 09/06/2006 |
| Last Update Date | 29/12/2010 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 79-0804G | (05) | NC |
| T83248 | (02) | NC |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.