Individual
DR. DAVID J BLAZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
113 HIGHWAY 70 E, DICKSON, TN 37055-2080
(615) 441-4450
(615) 446-1357
Mailing address
127 CRESTVIEW PARK DR, DICKSON, TN 37055-2855
(615) 446-5121
(615) 446-1357
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD26023
TN
207RI0011X
Interventional Cardiology Physician
MD26023
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060061304
RAILROAD MEDICARE PIN
—
05
—
3086151
—
TN
01
—
3158418
BLUE CROSS BLUE SHIELD TN
TN
Enumeration date
05/23/2005
Last updated
08/12/2015
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