Patricia Evelyn Blaylock

Primary specialty

PharmacistTaxonomy code 183500000X

License

PD06372 Issued in AR

Practice address

611 Highway 62 65 N
Harrison, AR 72601-2208

Phone

(870) 741-2118

Fax

(870) 741-3736

NPI assigned

Dec 22, 2020

Last updated

Dec 22, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1608595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1417544610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 HIGHWAY 62 65 N",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726012208",
            "telephone_number": "870-741-2268",
            "fax_number": "870-741-3736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 HIGHWAY 62 65 N",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726012208",
            "telephone_number": "870-741-2118",
            "fax_number": "870-741-3736"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "611 Highway 62 65 N",
            "address_purpose": "LOCATION",
            "city": "Harrison",
            "state": "AR",
            "postal_code": "726012208",
            "country_code": "US",
            "telephone_number": "870-741-2268",
            "fax_number": "870-741-3736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAYLOCK",
        "first_name": "PATRICIA",
        "middle_name": "EVELYN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-22",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "PD06372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Harrison, AR
• Providers in Harrison, AR by specialty
• Pharmacist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2020; 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.