Individual
DR. RICHARD JAY BLACKBURN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
705 WASHINGTON ST, RAVENSWOOD, WV 26164-1729
(304) 868-6000
(304) 868-6002
Mailing address
705 WASHINGTON ST, RAVENSWOOD, WV 26164-1729
(304) 868-6000
(304) 868-6002
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1455
WV
Other
Enumeration date
12/16/2005
Last updated
07/08/2007
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