Individual
JACOB BLACKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
306 KIRBY RD, KING, NC 27021-9493
(336) 983-4313
(336) 983-3500
Mailing address
PO BOX 4370, ARCHDALE, NC 27263-4370
(336) 687-7730
(336) 434-6680
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2805
NC
Other
Enumeration date
03/25/2024
Last updated
09/03/2025
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