Individual
SCOTT BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2202 STATE AVE STE 111, PANAMA CITY, FL 32405-4539
(850) 780-2141
Mailing address
2202 STATE AVE STE 111, PANAMA CITY, FL 32405-4539
(850) 780-2141
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
21299
FL
208600000X
Surgery Physician
22156
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00900834
—
MS
Enumeration date
07/16/2008
Last updated
08/05/2024
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