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Individual
TERRANCE L BLACKFORD
Active
Individual
TERRANCE L BLACKFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
37196
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000231288
ANTHEM
—
01
—
1106100
PASSPORT
KY
01
—
1168051
PASSPORT
KY
01
—
340020112
RAILROAD MEDICARE
KY
05
—
64055122
—
KY
05
—
65909285
—
KY
01
—
7616735001
CIGNA
—
01
—
7771374
AETNA
—
Enumeration date
10/05/2006
Last updated
04/20/2017
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