Individual
DR. ELIZABETH A BLACHLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7375 W US HIGHWAY 52, NEW PALESTINE, IN 46163-8950
(317) 861-4171
(317) 861-5325
Mailing address
PO BOX 129, GREENFIELD, IN 46140-0129
(317) 468-6270
(317) 468-6268
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01046880A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000112800
ANTHEM PIN #
IN
05
—
200156140
—
IN
01
—
200311740
MEDICAID GROUP PIN #
IN
01
—
5259508
AETNA PIN #
IN
01
—
80156759
MEDICARE RAILROAD #
IN
Enumeration date
08/15/2005
Last updated
12/08/2010
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