| Doctor Name: | CHRISTOPHER BLACKWELL |
| NPI Number: | 1982964565 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CNP |
| License Number: | R871872 |
| Business Practice Address: | 200 Hospital Dr Tylertown, MS - 396672020 |
| Business Phone Number: | 6018765303 |
| Business Fax Number: | 6018760653 |
| Mailing Address: | 200 Hospital Dr, TYLERTOWN |
| State: | MS |
| Postal Code: | 396672020 |
| Phone Number: | 6018765303 |
| Fax Number: | 6018760653 |
| NPI Enumeration Date: | 05/17/2012 |
| NPI Last Update Date: | 06/20/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R871872 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |