Blalock, Travis Wayne
Blalock, Travis Wayne is an individual health care provider with primary practice located at 619 Ne 13Th St , Oklahoma City OK 73104-5001. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery, Allopathic & Osteopathic Physicians / Procedural Dermatology. Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery is his primary health care specialty. Blalock, Travis Wayne can be contacted via phone (405) 271-6110.Contact Information
Primary practice address
619 Ne 13Th St
Oklahoma City OK 73104-5001
Phone: (405) 271-6110
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery | 207ND0101X | 73100 | Georgia |
| Allopathic & Osteopathic Physicians / Procedural Dermatology | 207NS0135X | A116875 | California |
Profile Details
| NPI number | 1710195003 |
|---|---|
| LBN Legal business name | Blalock, Travis Wayne |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 18th, 2007 |
| Last updated | Feb 12th, 2021 - about 5 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.
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