Mr John Stephen Blackburn, CRNA is a
Nurse Anesthetist, Certified Registered based in Irmo, South Carolina. Mr John Stephen Blackburn is licensed to practice in Tennessee (license number 11770) and his current practice location is
7210g Broad River Rd, Irmo, South Carolina. He can be reached at his office (for appointments etc.) via phone at
(803) 407-5266.
NPI number for Mr John Stephen Blackburn is 1164490801 and his current mailing address is Po Box 1637, Irmo, South Carolina. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1164490801.
Provider's Profile
| Full Name | Mr John Stephen Blackburn |
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| Gender | Male |
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| Speciality | Nurse Anesthetist, Certified Registered |
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| Location | 7210g Broad River Rd, Irmo, South Carolina |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1164490801
- Provider Enumeration Date: 03/09/2006
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Mr John Stephen Blackburn such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1164490801 | NPI | - | NPPES |
| 11770 | Other | TN | APN |
| 60552 | Other | TN | RN |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 11770 (Tennessee) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr John Stephen Blackburn is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr John Stephen Blackburn, CRNA
Po Box 1637,
Irmo, SC 29063-1637
Ph: (803) 407-5266 | Mr John Stephen Blackburn, CRNA
7210g Broad River Rd,
Irmo, SC 29063-7972
Ph: (803) 407-5266 |
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