IndividualActive
Audrey Blacklock, MD, PHD
NPI 1912199159 · Ophthalmology Physician · N Kansas City, MO
Provider details
- NPI number
- 1912199159
- Entity type
- Individual
- Primary specialty
- Ophthalmology PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD, PHD
- Sex
- Female
- Sole proprietor
- No
- License
- 04-34305 (KS)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
2790 Clay Edwards Dr Ste 1240
N Kansas City, MO 64116-3253
Phone: (816) 842-2015
Fax: (816) 221-3713
Approximate (ZIP-level) locationGet directions
Mailing address
2790 Clay Edwards Dr Ste 1240
N Kansas City, MO 64116-3253
Registry dates
- Enumerated
- 2007-08-13
- Last updated
- 2022-10-06
- Certified
- 2022-10-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.