Individual
JAMES KEVIN BLACKBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
3700 SOUTHERN BLVD, KETTERING, OH 45429-1265
(937) 458-4932
(937) 522-7394
Mailing address
3104 SETON HILL DR, BELLBROOK, OH 45305-8767
(937) 344-7019
(937) 522-7394
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
03120530
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03120530
PHARMACIST
OH
Enumeration date
04/07/2020
Last updated
10/27/2022
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