Active NPI
William Allen Blalock, M.D.
- Neonatal-Perinatal Medicine Physician
- Augusta, GA
National Provider Identifier
1225082852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- 29588
- Practice address
- 1350 Walton Way
Augusta, GA 30901-2612 - Phone
- (706) 724-2791
- NPI assigned
- May 19, 2006
- Last updated
- May 27, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 29588 | GA | Primary |
Addresses
Primary practice location
1350 Walton Way
Augusta, GA 30901-2612
Mailing address
65 Conifer Cir
Augusta, GA 30909-4508
Phone (706) 737-5720
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29588 | GA | MD | Neonatal-Perinatal Medicine Physician |
| 2588 | GA | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1306454400000",
"number": "1225082852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "65 CONIFER CIR",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309094508",
"telephone_number": "706-737-5720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1350 WALTON WAY",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309012612",
"telephone_number": "706-724-2791"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLALOCK",
"first_name": "WILLIAM",
"middle_name": "ALLEN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-19",
"last_updated": "2011-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "GA",
"license": "29588",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Augusta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.