IndividualActive
John Blackenburg, O.D.
NPI 1275563694 · Optometrist · Selma, AL
John Blackenburg, O.D. is a Optometrist provider in Selma, AL (NPI 1275563694).
Provider details
- NPI number
- 1275563694
- Entity type
- Individual
- Primary specialty
- OptometristEye and Vision Services Providers
- Credential
- O.D.
- Sex
- Male
- Sole proprietor
- Yes
- License
- S498-TA014 (AL)
Practice location
700 Dallas Ave
Selma, AL 36701-5451
Phone: (850) 622-0364
Fax: (850) 622-0364
Street-level locationGet directions
Mailing address
2080 Olde Towne Ave
Miramar Beach, FL 32550-6500
Registry dates
- Enumerated
- 2006-07-03
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.