Individual
GARY CHRISTOPHER BLOUNT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
641 RB WILSON DR STE G, HUNTINGDON, TN 38344-1734
(731) 986-7400
Mailing address
965 RIDGE LAKE BLVD STE 103, MEMPHIS, TN 38120-9446
(901) 227-3255
(901) 227-8591
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1075
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3380640
GROUP MEDICARE NUMBER
TN
Enumeration date
06/10/2005
Last updated
02/27/2019
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