Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. AUDREY DEANNE BLACKLOCK, MD, PHD

Active

Ophthalmology · N KANSAS CITY, MO

Registration Details

NPI Number: 1912199159
Provider Type: Individual
Gender: Female
NPI Issued: Aug 13, 2007 (18.731028128839 yrs)
Last Updated: Oct 6, 2022
Licenses: 04-34305 (KS)

2012008166 (MO)

Practice Information

Address: 2790 CLAY EDWARDS DR STE 1240

N KANSAS CITY, MO, 641163253
Browse MO providers · Browse ZIP 64116
Phone: 8168422015
Fax: 8162213713
Primary Specialty: Ophthalmology
207W00000X
Additional Specialty: Ophthalmology

Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.