Blackburn, Scott Anthony

Blackburn, Scott Anthony is an individual health care provider with primary practice located at 15150 Fort St , Southgate MI 48195-1302. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Primary Care, which is considered as his primary health care specialty. Blackburn, Scott Anthony can be contacted via phone (734) 282-4800.

Contact Information

Primary practice address
15150 Fort St Southgate MI 48195-1302
Phone: (734) 282-4800
Fax: (734) 282-9302
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X 4704326782 Michigan

Profile Details

NPI number 1003554494
LBN Legal business name Blackburn, Scott Anthony
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 25th, 2022
Last updated Apr 12th, 2024 - about 8 months 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003554494 NPPES
Michigan Other 4704326782 STATE LICENSE

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