DR. ROBERT EARL BLACKWELDER M.D. NPI 1912992413

NPI Information

NPI: 1912992413
Provider Name: DR. ROBERT EARL BLACKWELDER, M.D.
Classification: Urology - 208800000X
Entity Type: Individual
Address:
260 HOSPITAL DR STE 201
UKIAH, CA
ZIP 95482
Phone: (707) 463-8000
Get Directions

DR. Robert Earl Blackwelder, M.D. is an urology in Ukiah, CA. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. DR. Robert Earl Blackwelder, M.D. NPI is 1912992413. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

260 HOSPITAL DR STE 201
UKIAH, CA
ZIP 95482-533
Phone: (707) 463-8000
Fax: (707) 462-1111

The enumeration date for this NPI number is 9/12/2005 and was last updated on 9/15/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208800000X	Urology		AB7832454	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	340004324	MEDICARE ID-TYPE UNSPECIFIED	CALIFORNIA	RAILROAD MEDICARE #
2	A24161	MEDICARE UPIN	CALIFORNIA
3	ZZZ99532Z	MEDICARE ID-TYPE UNSPECIFIED	CALIFORNIA	LAKEPORT PROVIDER #
4	ZZZ74887Z	MEDICARE ID-TYPE UNSPECIFIED	CALIFORNIA	UKIAH PROVIDER #
5	ZZZ99729Z	MEDICARE ID-TYPE UNSPECIFIED	CALIFORNIA	FORT BRAGG PROVIDER #
6	ZZZ74887Z	MEDICAID	CALIFORNIA
7	LAB11989F	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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