Blakeburn, Robert Van

Blakeburn, Robert Van is an individual health care provider with primary practice located at 800 Frisco Ave , Clinton OK 73601-3306. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Blakeburn, Robert Van can be contacted via phone (580) 323-2700.

Contact Information

Primary practice address
800 Frisco Ave Clinton OK 73601-3306
Phone: (580) 323-2700
Fax: (580) 323-2276
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 17199 Oklahoma
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 17199 Oklahoma

Profile Details

NPI number 1164419560
LBN Legal business name Blakeburn, Robert Van
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 30th, 2005
Last updated Apr 18th, 2012 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164419560 NPPES
Oklahoma MEDICAID 100110960A

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