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DAVID BLACKBURN MD
>> Family Medicine >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1295239408
Individual Registrant: DAVID BLACKBURN MD
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
715 E 9TH ST RECTOR, AR 72461-2705 US
Tel: 870-595-3596 Fax: --
Tel: 870-595-3596 Fax: --
Contact information for business:
1206 GORDON DUCKWORTH DR PIGGOTT, AR 72454-1911 US
Tel: 870-598-3881 Fax: --
Tel: 870-598-3881 Fax: --
Registration Information:
NPI: 1295239408
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 207Q00000X | Allopathic & Osteopathic Physicians Family Medicine | AR | E13950 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 271052001 | AR | 05 |
