Individual
DR. RICHARD E BLATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1240 JESSE JEWELL PKWY SE, SUITE 555, GAINESVILLE, GA 30501-3862
(770) 536-9864
Mailing address
1240 JESSE JEWELL PKWY SE, SUITE 555, GAINESVILLE, GA 30501-3862
(770) 536-9864
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
066992
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12322757
CAQH
GA
Enumeration date
01/17/2008
Last updated
03/10/2021
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