| Blaylock Medical Clinic Pa | |
|
130 E Walker St Greenville MS 38701-4766 | |
| (662) 332-7211 | |
| (662) 332-0442 |
| Full Name | Blaylock Medical Clinic Pa |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 130 E Walker St, Greenville, Mississippi |
| Authorized Official Name and Position | Darrell N Blaylock (M.D.) |
| Authorized Official Contact | 6623327211 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blaylock Medical Clinic Pa 130 E Walker St Greenville MS 38701-4766 Ph: (662) 332-7211 | Blaylock Medical Clinic Pa 130 E Walker St Greenville MS 38701-4766 Ph: (662) 332-7211 |
| NPI Number | 1326353798 |
|---|---|
| Provider Enumeration Date | 08/10/2010 |
| Last Update Date | 08/31/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326353798 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 04644 (Mississippi) | Primary |
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