Individual
ROGER J BLANDFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C, ATC
Contact information
Practice address
3000 EDWARD CURD LN, FRANKLIN, TN 37067-5791
(615) 791-2630
(615) 791-2639
Mailing address
317 SEVEN SPRINGS WAY STE 101, BRENTWOOD, TN 37027-4576
(615) 370-9992
(615) 370-9665
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
AL1436
FL
363A00000X
Physician Assistant
006042
GA
363A00000X
Physician Assistant
Primary
3915
TN
363A00000X
Physician Assistant
PA 9105450
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003108303B
—
GA
05
—
003108303C
—
GA
05
—
Q051014
—
TN
Enumeration date
09/30/2006
Last updated
05/14/2024
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