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BLACKBURN, ROY MANELL III       
This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
Practice Address: INSTITUTE FOR PHYSICAL WELLNESS AND INDEPENDENCE
803 N. DIXIE AVE. #234
ELIZABETHTOWN KY 42701

Address last updated on 8/1/2001
Phone #:
Fax #:
County: NOT OKLAHOMA
License: 19919
Dated: 7/27/1996
Expires: 7/1/2006
License Type: Medical Doctor
Specialty: Physical Medicine & Rehabilitation
Internal Medicine
Pain Management (Physical Medicine & Rehabilitatio
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: American Univ Of The Caribbean, Sch Of Med, St Maarten, Netherlands Antille
Graduated: 3 / 1987
CME Year: 2006
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications: AMERICAN BOARD OF PHYSICAL MEDICINE/REHABILITATION
New Patients: Yes
Medicaid: No
Medicare: Yes
   
HMO/PPO: None listed
Hospital Privileges: Hospital(s) Not In Oklahoma
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Locations: Hours: Languages:
INSTITUTE FOR PHYSICAL WELLNESS AND INDEPENDENCE
803 N. DIXIE AVE. #234
ELIZABETHTOWN KY 42701

Phone #:
Fax #:
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Spanish

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