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Individual

DR. HERMAN MACK BLANTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
600 MARY ST, EVANSVILLE, IN 47710-1674
(812) 450-7338
(812) 450-2193
Mailing address
PO BOX 3407, EVANSVILLE, IN 47733-3407
(812) 450-7338
(812) 450-2193

Taxonomy

Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
01077468A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
033102705
TX
01
1255391413
SCOTT AND WHITE HEALTH PLAN
TX
01
8V4241
BCBS TX
TX
01
P00466542
RR MEDICARE
TX
Enumeration date
03/23/2006
Last updated
08/24/2016
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