Organization
W, STANFORD BLALOCK, MD, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM STANFORD BLALOCK MD (OWNER)
(931) 906-9860
Entity
Organization
Contact information
Practice address
279 CLEAR SKY CT UNIT 3, CLARKSVILLE, TN 37043-5653
(931) 906-9860
(931) 906-9858
Mailing address
279 CLEAR SKY CT UNIT 3, CLARKSVILLE, TN 37043-5653
(931) 906-9860
(931) 906-9858
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
16583
TN
Other
Enumeration date
12/04/2006
Last updated
06/30/2015
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