Organization
JOHN B BLALOCK JR MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN B BLALOCK JR. MD (PRESIDENT JOHN B BLALOCK JR MD PC)
(205) 933-7301
Entity
Organization
Contact information
Practice address
2660 10TH AVE S, STE 238, BIRMINGHAM, AL 35205-1605
(205) 933-7301
(205) 933-7304
Mailing address
2660 10TH AVE S, STE 238, BIRMINGHAM, AL 35205-1605
(205) 933-7301
(205) 933-7304
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
9169
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00087171
—
AL
01
—
87171
BC BS OF AL
AL
Enumeration date
12/06/2005
Last updated
05/24/2010
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