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DR. WILLIAM F. BLACKERBY PH.D.

Clinical Neuropsychologist

Enid, Oklahoma

Provider NPI: 1447393889

Provider Information:
DR. WILLIAM F. BLACKERBY PH.D.
Gender: M
Sole Proprietor


Practice Location:
71 MEDICAL GROUP 527 GOTT ROAD VANCE AFB ENID, OK 73705 US
Tel: 580-213-7419  Fax: --

Business Mailing Address:
71 MEDICAL GROUP 527 GOTT ROAD VANCE AFB ENID, OK 73705 US
Tel: 580-213-7419  Fax: --

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
TNP1231
Y103TC0700XBehavioral Health & Social Service Providers
Psychologist
TN1231

Other Provider Identifiers:

IssuerNumberStateType
1519219TN05
CAQH PIN12163042TN01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







CLINICAL NEUROPSYCHOLOGIST JOBS OK - Page 1



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