Blake Jonathan Shourd, is a
Family Medicine physician based in Judsonia, Arkansas. Blake Jonathan Shourd is licensed to practice in Arkansas (license number NONE) and his current practice location is 2863 Highway 157, Judsonia, Arkansas. He can be reached at his office (for appointments etc.) via phone at
(501) 278-0175.
NPI number for Blake Jonathan Shourd is 1427887942 and his current mailing address is 2863 Highway 157, Judsonia, Arkansas. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1427887942.
Physician's Profile
| Full Name | Blake Jonathan Shourd |
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| Gender | Male |
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| Speciality | Family Medicine |
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| Location | 2863 Highway 157, Judsonia, Arkansas |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1427887942
- Provider Enumeration Date: 08/01/2024
- Last Update Date: 08/01/2024
Medical Identifiers
Medical identifiers for Blake Jonathan Shourd such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1427887942 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | NONE (Arkansas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Blake Jonathan Shourd is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Blake Jonathan Shourd,
2863 Highway 157,
Judsonia, AR 72081-9182
Ph: (501) 278-0175 | Blake Jonathan Shourd,
2863 Highway 157,
Judsonia, AR 72081-9182
Ph: (501) 278-0175 |
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