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Contact Information

BERT E BLACKWELL, DO
4538 S HARVARD AVE
TULSA, OK74135-2906
 Phone: 918-712-3377
 Fax: 918-712-3373
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Undersea and Hyperbaric Medicine

207PE0005X 93 Physician/Emergency Medicine
 

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for BERT E BLACKWELL · (Male)

NPI Number 1649221177
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 05/12/2006
Last updated 11/30/2017 - About 9 years ago
Sole proprietor 1 No
Identifiers
  • OK License # 3343
  • OK Medicaid 100188740C
Hospital affiliation(s)
  • CREEK NATION COMMUNITY HOSPITAL - (Critical Access)
    309 NORTH 14TH
    OKEMAH, OK 74859
  • OKMULGEE MEMORIAL HOSPITAL - (Acute Care)
    1401 MORRIS DRIVE
    OKMULGEE, OK 74447
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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