WILLIAM TATE BLALOCK (NPI# 1134148638) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134148638 |
| Entity Type | Individual |
| Full Name | WILLIAM TATE BLALOCK |
| Other Name | BILL BLALOCK |
| Credential | P.A.-C. |
| Practice Address |
Dogwood Ave Quillen Veterans Affairs Medical Center -bldg 204 Mountain Home TN 37684-4000 |
| Mailing Address |
Po Box 4000 Quillen Veterans Affairs Medical Center Mountain Home TN 37684-4000 |
| Practice Telephone | 4239793497 |
| Practice Fax Number | 4239792894 |
| Mailing Telephone | 4239793497 |
| Mailing Fax Number | 4239792894 |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2014-01-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 409 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 8923647 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760431316 | William E Blalock | Chiropractor | 118 Giles Dr, Boiling Springs, SC 29316-6033 | 2006-05-10 |
| 1447209325 | William S Blalock | Plastic Surgery | 279 Clear Sky Ct, Suite B, Clarksville, TN 37043-5653 | 2006-05-09 |
| 1225082852 | William Allen Blalock | Pediatrics | 1350 Walton Way, Augusta, GA 30901-2612 | 2006-05-19 |
| 1073570479 | William Oren Blalock | Internal Medicine | 1514 Jefferson Hwy, New Orleans, LA 70121-2429 | 2006-04-28 |
| 1740254820 | William E Blalock IIi | Internal Medicine | 1614 Gunbarrel Rd, Suite 101, Chattanooga, TN 37421 | 2006-02-15 |
| Street Address |
DOGWOOD AVE QUILLEN VETERANS AFFAIRS MEDICAL CENTER -BLDG 204 |
| City | MOUNTAIN HOME |
| State | TN |
| Zip Code | 37684-4000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144274069 | Rebecca Snyder Moss | Nurse Practitioner | Dogwood Ave, Building 160, Mountain Home, TN 37684 | 2006-05-22 |
| 1073992343 | Lakshmi Soujanya Kallur | Student in an Organized Health Care Education/Training Program | Dogwood Ave, Carl A. Jones Hall, Va Building 1, Mountain Home, TN 37684 | 2015-05-20 |
| 1801273669 | Tazley Ann Hobbs | Psychiatry & Neurology | Dogwood Ave, Va Bldg 52, Mountain Home, TN 37684 | 2015-04-30 |
| 1558532234 | Earl E Johnson | Audiologist | Dogwood Ave, Bldg 204 Audiology-126, Mountain Home, TN 37684-4000 | 2008-03-20 |
| 1356432744 | Lisa D Blankenship | Physical Medicine & Rehabilitation | Dogwood Ave, Vamc, Mountain Home, TN 63684 | 2006-09-28 |
| 1568406197 | Richard Cutlip | Pharmacist | Dogwood Ave, Vamc, Bldg 69, Mountain Home, TN 37684 | 2006-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235730524 | Kendra Lee Thorne | Psychologist | Corner of Lamont St and Veterans Way, Building 160, Mountain Home, TN 37684 | 2020-11-04 |
| 1255930160 | Maximillian Scott Crockett | Optometrist | James. H Quillen Vamc, Eye Clinic 112e, Mountain Home, TN 37684 | 2020-10-21 |
| 1699393256 | Joshua Thomas Spencer | Pharmacist | Veterans Way and Lamont St, Mountain Home, TN 37684 | 2020-07-10 |
| 1073140265 | James Hankil Kim | Student in an Organized Health Care Education/Training Program | Building 52/lake Drive, Mountain Home, TN 37684 | 2020-03-26 |
| 1932736030 | Trishna Sharma | Student in an Organized Health Care Education/Training Program | Building 52/lake Drive Mountain Home, Johnson City, TN 37684 | 2020-03-26 |
| 1508421884 | Sarvatit Patel | Student in an Organized Health Care Education/Training Program | 52 Lake Dr, Mountain Home, TN 37684 | 2019-05-02 |
| 1902366024 | Katelyn Cserjes | Student in an Organized Health Care Education/Training Program | Building 52 Lake Drive Va Medical Center, Mountain Home, TN 37684 | 2019-03-24 |
| 1114404282 | Anesa Ellen Hughes | Pharmacist | Veterans Way and Lamont St Mountain Home, Mountain Home, TN 37684 | 2018-07-23 |
| 1508352287 | Leon Nguyen | Optometrist | James H. Quillen Vamc - Lamont St & Veterans Way, Eye Clinic 112e, Mountain Home, TN 37684 | 2018-07-06 |
| 1649761750 | Bahaaeldin Ibrahim Mahmoud Youssef | Student in an Organized Health Care Education/Training Program | Va Building 1 Carl A Jones Hall, Dogwood Avenue, Mountain Home, TN 37684 | 2018-05-24 |
| Find all providers in zip 37684 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821304007 | Melissa A Walsh | Physician Assistant | 110 Rattlesnake Ave Ste B, Mountain Home, ID 83647-4220 | 2010-08-25 |
| 1821022732 | Kevin John Mccoy | Physician Assistant | Sidney and Lamont St, Mountain Home, TN 37684 | 2006-07-10 |
| 1427555119 | Jamie Knapp | Physician Assistant | 465 Mckenna Dr, Mountain Home, ID 83647-2143 | 2018-04-09 |
| 1265852909 | Whitney Ann Roberts | Physician Assistant | 465 Mckenna Dr, Mountain Home, ID 83647-2143 | 2014-04-21 |
| 1902231178 | Interventional Pain Management Associates Pllc | Physician Assistant | 17 Medical Plz, Mountain Home, AR 72653-2918 | 2013-09-06 |
| 1548500770 | Niger Stice | Physician Assistant | 17 Medical Plaza, Mountain Home, AR 72653-2918 | 2013-02-25 |
| 1912156068 | Diana Sue Riley | Physician Assistant | 628 Hospital Dr, Suite G-c, Mountain Home, AR 72653-2953 | 2008-09-13 |
| 1356549901 | Jeffery D Tate | Physician Assistant | 555 W 6th St, Mountain Home, AR 72653-3409 | 2007-07-05 |
| 1063578664 | Doctors Clinic of Elmore County Pllc | Physician Assistant | 2000 American Legion Blvd, Mountain Home, ID 83647-3138 | 2006-12-28 |
| 1356438394 | Russell Franklin Lawrence | Physician Assistant | Veterans Affairs Medical Center, Lamont and Sydney Streets, Mountain Home, TN 37684-4000 | 2006-10-10 |
| Find all providers in MOUNTAIN HOME | ||||
| City | MOUNTAIN HOME |
| Zip Code | 37684 |
Please comment or provide details below to improve the information on WILLIAM TATE BLALOCK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.