Blackburn, Jeffery B
Blackburn, Jeffery B is an individual health care provider with primary practice located at 1001 Xenia Ave , Yellow Springs OH 45387. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Blackburn, Jeffery B can be contacted via phone (937) 767-7369.Contact Information
Primary practice address
1001 Xenia Ave
Yellow Springs OH 45387
Phone: (937) 767-7369
Fax: (937) 767-7703
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 35032201 | Ohio |
Profile Details
| NPI number | 1679539498 |
|---|---|
| LBN Legal business name | Blackburn, Jeffery B |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 21st, 2006 |
| Last updated | Jul 26th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679539498 | NPPES |
| Ohio | MEDICAID | 0145793 |
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