Individual
DR. JEFFERY B BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1001 XENIA AVE, YELLOW SPRINGS, OH 45387
(937) 767-7369
(937) 767-7703
Mailing address
1 EAST PLEASANT STREET, SPRINGFIELD, OH 45506
(937) 328-7266
(937) 328-5276
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35032201
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0145793
—
OH
Enumeration date
04/21/2006
Last updated
07/26/2011
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