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Individual

DAVID BLACKBURN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
715 E 9TH ST, RECTOR, AR 72461-2705
(870) 595-3596
Mailing address
1206 GORDON DUCKWORTH DR, PIGGOTT, AR 72454-1911
(870) 598-3881

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E13950
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
271052001
AR
Enumeration date
03/21/2018
Last updated
10/01/2021
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