John C Blackenburg OD LLC
Organization Active NPI Optometrist · Semmes, AL
NPI 1679896344 · NPPES record last updated Aug 3, 2010
Key facts
- NPI
- 1679896344
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- S498TA014 (AL)
- Legal business name
- JOHN C BLACKENBURG OD LLC
- Practice address
- 7930 Moffett Rd
Semmes, AL 36575-5490 - Phone
- (251) 645-2991
- Fax
- (251) 645-0723
- NPI assigned
- Mar 9, 2010
- Organization subpart
- No
Authorized official
- Name
- Dr. John C Blackenburg, OD
- Title
- Owner
- Phone
- (251) 645-2991
Practitioners 1
-
John C. Blackenburg, O.D.
National Provider Directory
Locations
7930 Moffett Rd
Semmes, AL 36575
Phone (251) 645-2991
7930 Moffett Rd
Ste B
Semmes, AL 36575
Phone (251) 476-5050
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | S498TA014 | AL | Yes |
Addresses
Primary practice location
7930 Moffett Rd
Semmes, AL 36575-5490
Mailing address
7930 Moffett Rd
Semmes, AL 36575-5490
Phone (251) 645-2991
Other providers in Semmes, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 3, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.