Individual
STEPHEN K. BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2801 MEDICAL CENTER DR, POCAHONTAS, AR 72455-9436
(800) 893-9698
Mailing address
1150 DIAMOND HEAD RD, DRASCO, AR 72530-9156
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
C5367
AR
Other
Enumeration date
05/03/2006
Last updated
07/08/2007
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