# JACK H BLALOCK JR, MD, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295073070
- **Authorized official:** JACK H BLALOCK JR. MD (CEO)
- **Authorized official phone:** (706) 327-4317

## Contact information

- **Practice address:** 2300 MANCHESTER EXPY, STE F1, COLUMBUS, GA 31904-6802
- **Practice address phone:** (706) 660-8505
- **Practice address fax:** (706) 660-1454
- **Mailing address:** 2300 MANCHESTER EXPY, STE F1, COLUMBUS, GA 31904-6802
- **Mailing address phone:** (706) 660-8505
- **Mailing address fax:** (706) 660-1454

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | 012675 | GA | Yes |

## Other

- **Enumeration date:** 01/29/2013
- **Last updated:** 01/29/2013