Individual
MELROSE INGLE BLACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6215 HUMPHREYS BLVD STE 300, MEMPHIS, TN 38120-2382
(901) 757-0229
(901) 757-9503
Mailing address
965 RIDGE LAKE BLVD STE 103, MEMPHIS, TN 38120-9446
(901) 227-8591
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
0000015010
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3726929
—
TN
Enumeration date
10/17/2006
Last updated
04/15/2021
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