Organization
ROBERT V BLAKEBURN MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT VAN BLAKEBURN MD (PRESIDENT/OWNER)
(580) 323-2700
Entity
Organization
Contact information
Practice address
800 FRISCO AVE, CLINTON, OK 73601-3306
(580) 323-2700
(580) 323-2718
Mailing address
800 FRISCO AVE, CLINTON, OK 73601-3306
(580) 323-2700
(580) 323-2718
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17199
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100110960C
—
OK
Enumeration date
09/30/2005
Last updated
04/01/2026
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