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Individual

DR. RICHARD BLALOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
805 CAMPBELL HILL ST NW, MARIETTA, GA 30060-1144
(404) 752-1400
Mailing address
805 CAMPBELL HILL ST NW, MARIETTA, GA 30060-1144
(404) 752-1400

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301092835
MI
208000000X
Pediatrics Physician
4301092835
MI

Other

Enumeration date
07/14/2008
Last updated
08/21/2013
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