Blalock, David Justin

Blalock, David Justin is an individual health care provider with primary practice located at 515 Carlton St , Wauchula FL 33873-3407. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Blalock, David Justin can be contacted via phone (863) 773-6606.

Contact Information

Primary practice address
515 Carlton St Wauchula FL 33873-3407
Phone: (863) 773-6606
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X ARNP2833192 Florida

Profile Details

NPI number 1922076124
LBN Legal business name Blalock, David Justin
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2006
Last updated Aug 26th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1922076124 NPPES
Florida MEDICAID 306580400

Popular Providers