Organization
WILLIAM S BLAKEMORE MD LTD
Active
Organization
WILLIAM S BLAKEMORE MD LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM S BLAKEMORE M.D. (PRESIDENT CORP.)
(252) 482-7471
Entity
Organization
Contact information
Practice address
101 MARK DR, EDENTON, NC 27932-1704
(252) 482-7471
(252) 482-5465
Mailing address
101 MARK DR, EDENTON, NC 27932-1704
(252) 482-7471
(252) 482-5465
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
24730
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0131V
BLUE CROSS GROUP NUMBER
NC
05
—
890131V
—
NC
01
—
CG5520
RAILROAD MEDICARE
NC
Enumeration date
05/20/2006
Last updated
02/03/2015
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