Blaine Randall Blakestad MD PA

NPI #1124346598 in Lufkin, Texas

Provider Information

NPI Number
1124346598
Entity Type
Organization
Organization Name
Blaine Randall Blakestad MD PA
Primary Specialty
Preventive Medicine - Undersea and Hyperbaric Medicine
Enumeration Date
May 11, 2010
Last Updated
Sep 9, 2010

Practice Location

Address
1201 W FRANK AVE
City
Lufkin
State
Texas
ZIP Code
75904-3357
Phone
(936) 634-8111

Authorized Official

Name
DR. BLAINE RANDALL BLAKESTAD, MD
Title
PRESIDENT
Phone
(936) 632-5894

Specialties & Taxonomy Codes

Specialty
Preventive Medicine - Undersea and Hyperbaric MedicineUndersea and Hyperbaric Medicine

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