Individual
DR. ALAN RYAN BLACKBURN II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1050 SE MONTEREY RD STE 400, STUART, FL 34994-4512
(772) 288-2400
(772) 419-0144
Mailing address
1050 SE MONTEREY RD STE 400, STUART, FL 34994-4512
(772) 288-2400
(772) 419-0144
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
4772
GA
2086S0105X
Surgery of the Hand (Surgery) Physician
Primary
ME130977
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
JD517Z
MEDICARE
—
Enumeration date
06/28/2011
Last updated
11/19/2018
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