Individual
DR. JIMMY BLACKBURN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1500 E DOWNING ST STE 6, TAHLEQUAH, OK 74464-3234
(918) 456-0694
Mailing address
1500 E DOWNING ST STE 6, TAHLEQUAH, OK 74464-3234
(918) 456-0694
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15235
OK
Other
Enumeration date
08/07/2014
Last updated
07/21/2022
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