Jack H Blalock Jr, MD, PC

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

012675 Issued in GA

Legal business name

JACK H BLALOCK JR, MD, PC

Practice address

2300 Manchester Expy
Ste F1
Columbus, GA 31904-6802

Phone

(706) 660-8505

Fax

(706) 660-1454

NPI assigned

Jan 29, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jack H Blalock Jr., MD

Title

Ceo

Phone

(706) 327-4317

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1359417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359417600000",
    "number": "1295073070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 MANCHESTER EXPY",
            "address_2": "STE F1",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319046802",
            "telephone_number": "706-660-8505",
            "fax_number": "706-660-1454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 MANCHESTER EXPY",
            "address_2": "STE F1",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319046802",
            "telephone_number": "706-660-8505",
            "fax_number": "706-660-1454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK H BLALOCK JR, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-29",
        "last_updated": "2013-01-29",
        "status": "A",
        "authorized_official_last_name": "BLALOCK",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "706-327-4317",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "GA",
            "license": "012675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Endocrinology, Diabetes & Metabolism Physician in Columbus, GA
• Providers in Columbus, GA by specialty
• Endocrinology, Diabetes & Metabolism Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.