Provider Demographics
NPI:1841571676
Name:BLACKBURN, RODNEY BUDDY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:BUDDY
Last Name:BLACKBURN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2209 RICHMOND RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-1306
Mailing Address - Country:US
Mailing Address - Phone:859-269-8832
Mailing Address - Fax:859-269-3186
Practice Address - Street 1:2209 RICHMOND RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502-1306
Practice Address - Country:US
Practice Address - Phone:859-269-8832
Practice Address - Fax:859-269-3186
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-07
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY012034183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist