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Contact Information

DREW S BLACKSTOCK, MD
6630 SUMMER KNOLL CIR STE 101
BARTLETT, TN38134
 Phone: 901-746-9438
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Addiction Medicine

207QA0401X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for DREW S BLACKSTOCK · (Male)

NPI Number 1841532819
Status Active
Credentials MD
Entity Individual
Enumeration date 03/18/2013
Last updated 08/08/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • TN License # 51931
  • MO Medicaid 1841532819
  • MS Medicaid 02237563
  • TN Medicaid Q008983
Hospital affiliation(s)
  • NORTH MISSISSIPPI MEDICAL CENTER - (Acute Care)
    830 S GLOSTER
    TUPELO, MS 38801
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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