DR. John C. Blackenburg, O.D.

NPI #1275563694 in Selma, Alabama

Provider Information

NPI Number: 1275563694
Entity Type: Individual
Name: DR. John C. Blackenburg, O.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Optometrist
Credential: O.D.
Enumeration Date: Jul 3, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 700 DALLAS AVE
City: Selma
State: Alabama
ZIP Code: 36701-5451
Phone: (850) 622-0364

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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