OrganizationActive
Blackwell'S Family Medicine LLC
NPI 1366003436 · Primary Care Clinic/Center · Tylertown, MS
Provider details
- NPI number
- 1366003436
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Chrisotpher Blackwell, Owner, Provider(601) 377-1975
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(66/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
107 Ball Ave
Tylertown, MS 39667-2101
Phone: (601) 303-8264
Approximate (ZIP-level) locationGet directions
Mailing address
171 Pigott Easterling Rd
Tylertown, MS 39667-7222
Registry dates
- Enumerated
- 2019-06-27
- Last updated
- 2021-03-15
- Certified
- 2021-03-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.