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Contact Information

BEN D BLACKBURN, DPH
16657 E 122ND ST N
COLLINSVILLE, OK74021-5180
 Phone: 918-688-8578
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pharmacist

183500000X
Indicates primary specialty

NPI Profile & details for BEN D BLACKBURN · (Male)

NPI Number 1932480498
Status Active
Credentials DPH
Entity Individual
Enumeration date 08/29/2011
Last updated 08/29/2011 - About 15 years ago
Sole proprietor 1 Yes
Identifiers
  • OK License # 12179
  • OK Medicaid 100234240
  • OK Medicaid 100234240T
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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