Individual
DR. LARRY MARK BLATTNER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2000 WEST BETHANY HOME ROAD, PHOENIX BAPTIST HOSPITAL, PHOENIX, AZ 85015
(480) 731-4714
(480) 731-5425
Mailing address
PO BOX 56116, PHOENIX, AZ 85079
(480) 731-4714
(480) 731-5425
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
DO2336
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
299059
—
AZ
Enumeration date
11/16/2005
Last updated
07/08/2007
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