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Individual

DR. CALVIN L BLOUNT JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
12607 US HIGHWAY 98 W, MIRAMAR BEACH, FL 32550-6825
(850) 837-4844
(850) 837-6625
Mailing address
4012 COMMONS DR W, STE 120, DESTIN, FL 32541-8424
(850) 837-4844
(850) 837-6625

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME76428
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080146219
MDC RAILROAD
FL
05
255279500
FL
01
44250
BLUE CROSS BLUE SHIELD
FL
01
5903676
AETNA INSURANCE
FL
01
593553504
CHAMPUS
FL
01
ME76428
STATE LICENSE
FL
Enumeration date
11/20/2005
Last updated
03/07/2023
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