Individual
ERIC D BLAKNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6005 PARK AVE STE 200, MEMPHIS, TN 38119-5212
(901) 761-2100
(901) 761-1442
Mailing address
PO BOX 22403, BELFAST, ME 04915-4476
(888) 402-7256
(888) 902-1099
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
30789
TN
207RC0000X
Cardiovascular Disease Physician
218961
MS
208M00000X
Hospitalist Physician
21896
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
260110399
AETNA
TN
01
—
260110399
CIGNA
—
01
—
3837940
MEDICARE ID-TYPE UNSPECIFIED
TN
01
—
4108654
BLUECROSS BLUESHIELD
TN
Enumeration date
08/12/2005
Last updated
09/29/2025
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