Individual
WARREN D BLACKBURN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
408 CLARK ST NE, CULLMAN, AL 35055-1953
(256) 734-3202
(256) 734-4668
Mailing address
503 CLARK ST NE, CULLMAN, AL 35055-1921
(256) 739-1759
(256) 739-0027
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
10239
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009982800
—
AL
01
—
51007164
BCBS OF AL
AL
01
—
E873
MEDICARE GROUP #
AL
Enumeration date
11/09/2005
Last updated
01/24/2014
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