# MED EX PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598718074
- **Authorized official:** RICHARD J. BLACKBURN DO (PRESIDENT)
- **Authorized official phone:** (800) 824-2543

## Contact information

- **Practice address:** 705 WASHINGTON ST, RAVENSWOOD, WV 26164-1729
- **Practice address phone:** (800) 824-2543
- **Practice address fax:** (330) 862-2356
- **Mailing address:** 705 WASHINGTON ST, RAVENSWOOD, WV 26164-1729
- **Mailing address phone:** (800) 824-2543
- **Mailing address fax:** (330) 862-2356

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | — | NULL | — |
| 103T00000X | Psychologist | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/18/2006
- **Last updated:** 10/16/2007