Blaylock Medical Clinic PA
NPI #1326353798 in Greenville, Mississippi
Provider Information
- NPI Number
- 1326353798
- Entity Type
- Organization
- Organization Name
- Blaylock Medical Clinic PA
- Primary Specialty
- Clinic/Center - Primary Care
- Enumeration Date
- Aug 10, 2010
- Last Updated
- Aug 31, 2010
Practice Location
- Address
- 130 E WALKER ST
- City
- Greenville
- State
- Mississippi
- ZIP Code
- 38701-4766
- Phone
- (662) 332-7211
Authorized Official
- Name
- DARRELL N BLAYLOCK, M.D.
- Title
- M.D.
- Phone
- (662) 332-7211
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Primary Care — Primary Care |
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