MEDICARE: DR. ARTHUR BERT BLACKBURN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	G4832	TX

General Provider Information

NPI Number	:	1619956455
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARTHUR BERT BLACKBURN M.D.

Provider Business Mailing Address
First Line	:	1733 CURIE DR
Second Line	:	STE 300
City	:	EL PASO
State	:	TX
Zip	:	79902-2910
Country	:	US
Telephone Number	:	915-532-3906
Fax Number	:	915-532-1330

Provider Business Practice Location Address
First Line	:	1733 CURIE DR
Second Line	:	STE 300
City	:	EL PASO
State	:	TX
Zip	:	79902-2910
Country	:	US
Telephone Number	:	915-532-3906
Fax Number	:	915-532-1330

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2006
Last Update Date	:	07/12/2019

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