Blaine Randall Blakestad, MD

NPI #1881641975 in Lufkin, Texas

Provider Information

NPI Number: 1881641975
Entity Type: Individual
Name: Blaine Randall Blakestad, MD
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: General Practice
Credential: MD
Enumeration Date: May 27, 2006
Last Updated: Sep 29, 2020

Practice Location

Address: 1201 W FRANK AVE
City: Lufkin
State: Texas
ZIP Code: 75904-3357
Phone: (936) 639-7696

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Preventive Medicine - Undersea and Hyperbaric Medicine — Undersea and Hyperbaric Medicine	2083P0011X
Thoracic Surgery (Cardiothoracic Vascular Surgery)	208G00000X
General Practice	208D00000X	Primary

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