NPI 1255301016 · live from the CMS NPI Registry
Carol Lee Blackwood, MD
Family Medicine in White River Junction, VT. National Provider Identifier 1255301016, active.
NPI record
| NPI | 1255301016 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Family Medicine 207Q00000X |
| Practice location | 215 N Main St, Veterans Affairs Medical Center, White River Junction, VT 05009 |
| Practice phone | 802-742-0415 |
| Enumerated | January 25, 2006 |
| Last updated | April 22, 2011 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine | 207Q00000X | 2005-00643 (NC) |
| Family Medicine primary | 207Q00000X | 042-0009782 (VT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.