Individual
DR. WILLIAM BLAYLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1930 BRAEBURN CIR, SALEM, VA 24153-7388
(540) 444-5600
(540) 444-5617
Mailing address
1930 BRAEBURN CIR, SALEM, VA 24153-7388
(540) 444-5600
(540) 444-5617
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
0101018545
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006095291
—
VA
01
—
P00276848
MEDICARE RAILROAD
VA
Enumeration date
12/16/2005
Last updated
08/25/2015
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