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Individual
HAROLD JASON BLALOCK
Active
Individual
HAROLD JASON BLALOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
17167
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0124443
—
MS
01
—
02701951231
AMERICAN MEDICAL ASSOC.
MS
01
—
13012
AMERICAN BOARD OF UROLOGY
MS
01
—
340019033
MEDICARE - RAILROAD
MS
Enumeration date
07/02/2006
Last updated
08/01/2019
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