BLAYLOCK MEDICAL CLINIC PA (NPI# 1326353798) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326353798 |
| Entity Type | Organization |
| Organization Name | BLAYLOCK MEDICAL CLINIC PA |
| Practice Address |
130 E Walker St Greenville MS 38701-4766 |
| Practice Telephone | 6623327211 |
| Practice Fax Number | 6623320442 |
| Mailing Telephone | 6623327211 |
| Mailing Fax Number | 6623320442 |
| Enumeration Date | 2010-08-10 |
| Last Update Date | 2010-08-31 |
| Authorized Official Name | DARRELL N BLAYLOCK (M.D.) |
| Authorized Official Telephone | 6623327211 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
04644 | MS | Ambulatory Health Care Facilities |
| Street Address |
130 E WALKER ST |
| City | GREENVILLE |
| State | MS |
| Zip Code | 38701-4766 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750373809 | Darrell Nolon Blaylock | Internal Medicine | 130 E Walker St, Greenville, MS 38701-4766 | 2005-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851882328 | G & M Transportation LLC | Non-emergency Medical Transport (VAN) | 1525 South Dr. Mlk Dr, Suite E, Greenville, MS 38701 | 2018-05-21 |
| 1528564143 | Gyton Brijjetta Williams | Nurse Practitioner | 1400 East Union Street, Greenville, MS 38701 | 2018-04-03 |
| 1225552557 | Stephanie Epley | Counselor | 365 West Reed Rd Ste A-1, Greenville, MS 38701 | 2017-07-28 |
| 1861943425 | Roderick Montgomery | Non-emergency Medical Transport (VAN) | 537 Patricia Dr, Greenville, MS 38701 | 2016-10-19 |
| 1649694183 | Denise Wright | Nurse Practitioner | 1746-c Ms State Hwy 1 South, Greenville, MS 38701 | 2014-02-04 |
| 1174953525 | Sharkey-issaquena Adult Daycare | Psychologist | 449 Oakland Drive, Greenville, MS 38701 | 2013-11-21 |
| 1881953198 | New Hope Prosthetics & Orthodics Inc | Prosthetic/Orthotic Supplier | 585 Tennessee Gas Rd, Greenville, MS 38701 | 2012-05-07 |
| 1306139928 | Delta Regional Medical Center | Psychiatric Hospital | 300 South Washington Ave., Greenville, MS 38701 | 2011-05-17 |
| 1730305871 | First Choice Home Medical Equipment Inc. | Durable Medical Equipment & Medical Supplies | 428 Highway 82 East, Greenville, MS 38701 | 2007-04-17 |
| 1750435301 | Greg Heath Hairston | Chiropractor | 871 Hwy 1 South, Greenville, MS 38701 | 2007-01-22 |
| Find all providers in zip 38701 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477979672 | Rmcca Clinic A, LLC | Clinic/Center | 300 N College Street, Greenville, AL 36037 | 2014-03-12 |
| 1144669375 | Delta Wellness Clinic for Families LLC | Clinic/Center | 1585 S Main St, Greenville, MS 38701-7008 | 2013-06-20 |
| 1871826743 | Ambulatory Medicine Associates, LLC | Clinic/Center | 532 Sulphur Springs Rd, Greenville, SC 29617-6206 | 2009-09-10 |
| 1376798546 | Greenville Specialty Clinic | Clinic/Center | 1508 Hospital St, Greenville, MS 38703-3219 | 2008-12-01 |
| 1588835243 | Mauldin Medical Associates | Clinic/Center | 3443 Pelham Rd, Suite 200, Greenville, SC 29615-4178 | 2008-03-20 |
| 1831172279 | Mauldin Medical Associates, Pa | Clinic/Center | 545 W Butler Rd, Greenville, SC 29607-4833 | 2005-11-21 |
| 1679171995 | New Hope Medical Primary & Urgent Care Clinic, LLC | Clinic/Center | 585 Tennessee Gas Rd, Greenville, MS 38701-8143 | 2020-10-09 |
| 1417481474 | The Downtown Family Clinic, LLC | Clinic/Center | 345 Washington Ave, Greenville, MS 38701-3615 | 2017-04-17 |
| 1710410816 | Fayette County Hospital District | Clinic/Center | 308 W College Ave, Greenville, IL 62246 | 2017-04-05 |
| 1124481791 | Family Care Clinic, Pllc | Clinic/Center | 1440 Highway 1 S, Greenville, MS 38701-7140 | 2016-04-01 |
| Find all providers in GREENVILLE | ||||
| City | GREENVILLE |
| Zip Code | 38701 |
Please comment or provide details below to improve the information on BLAYLOCK MEDICAL CLINIC PA.
| 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.