# TERRANCE L BLACKFORD

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1588750509
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | 37196 | KY | Yes |

## Other

- **Enumeration date:** 10/05/2006
- **Last updated:** 04/20/2017

## 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 | — |