Individual
DR. RICHARD E BLALOCK
Active
Individual
DR. RICHARD E BLALOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20341
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000050313
ANTHEM BC BS
KY
01
—
110001757
RAILROAD MEDICARE
KY
01
—
610994960
TAX ID
KY
05
—
64203417
—
KY
Enumeration date
10/12/2005
Last updated
03/05/2018
Update your record
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