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Individual
TULLY T. BLALOCK JR.
Active
Individual
TULLY T. BLALOCK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME26001
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002048700
—
FL
Enumeration date
01/04/2007
Last updated
09/12/2011
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