Organization
JAMES M BLAYLOCK MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES MATTISON BLALOCK MD (PRESIDENT)
(405) 272-6909
Entity
Organization
Contact information
Practice address
608 NW 9TH ST, SUITE 6110, OKLAHOMA CITY, OK 73102-1049
(405) 272-6909
(405) 231-3723
Mailing address
PO BOX 269086, OKLAHOMA CITY, OK 73126
(405) 231-3857
(405) 942-7743
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
12285
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200080450A
—
OK
01
—
DF0246
GROUP RAILROAD MCARE
OK
Enumeration date
06/06/2006
Last updated
06/04/2010
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