Blaylock, Justin

Blaylock, Justin is an individual health care provider with primary practice located at 1814 Westchester Dr Ste 201, High Point NC 27262-7369. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Blaylock, Justin can be contacted via phone (336) 802-2090.

Contact Information

Primary practice address
1814 Westchester Dr Ste 201 High Point NC 27262-7369
Phone: (336) 802-2090
Fax: (336) 802-2091
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 955 South Carolina

Profile Details

NPI number 1871548909
LBN Legal business name Blaylock, Justin
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2006
Last updated Dec 30th, 2009 - about 17 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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Identifiers

StateTypeNumberIssuer
All States NPI 1871548909 NPPES
South Carolina Other 955 PA LICENSE

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