Doctor Name: | MARK H BLANCHARD |
NPI Number: | 1225010382 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 043555 |
Business Practice Address: | 3131 S Main St Moultrie, GA - 317686925 |
Business Phone Number: | 2299858802 |
Business Fax Number: | 2298912016 |
Mailing Address: | Po Box 2977, MOULTRIE |
State: | GA |
Postal Code: | 317762977 |
Phone Number: | 2299858802 |
Fax Number: | 2298912016 |
NPI Enumeration Date: | 11/15/2005 |
NPI Last Update Date: | 10/05/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0202X |
License Number: | 043555 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Diagnostic Radiology |
Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |