Individual
PAUL A. BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2601 E ROOSEVELT ST, PHOENIX, AZ 85008-4973
(602) 344-5011
(602) 344-5907
Mailing address
2929 E THOMAS RD, PHOENIX, AZ 85016-8034
(602) 470-5000
(602) 344-5907
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2680
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116063
—
AZ
Enumeration date
05/20/2006
Last updated
03/27/2013
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