Individual
DR. SEAN G. BLACKBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
927 23RD AVE, SIDNEY, NE 69162-1418
(308) 254-5115
Mailing address
PO BOX 17, SIDNEY, NE 69162-0017
(308) 254-5115
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1066
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
470799621
—
NE
Enumeration date
11/08/2006
Last updated
09/17/2024
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