Individual
ADAM J BLACKMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1923 S UTICA AVE, TULSA, OK 74104-6520
(918) 744-3664
(918) 293-3178
Mailing address
1923 S UTICA AVE, TULSA, OK 74104-6520
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
101534
OK
Other
Enumeration date
12/28/2015
Last updated
12/28/2015
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