W, Stanford Blalock, MD, PLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

16583 Issued in TN

Legal business name

W, STANFORD BLALOCK, MD, PLC

Practice address

279 Clear Sky CT Unit 3
Clarksville, TN 37043-5653

Phone

(931) 906-9860

Fax

(931) 906-9858

NPI assigned

Dec 4, 2006

Last updated

Jun 30, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. William Stanford Blalock, MD

Title

Owner

Phone

(931) 906-9860

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435622400000",
    "number": "1548328776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 CLEAR SKY CT UNIT 3",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370435653",
            "telephone_number": "931-906-9860",
            "fax_number": "931-906-9858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 CLEAR SKY CT UNIT 3",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370435653",
            "telephone_number": "931-906-9860",
            "fax_number": "931-906-9858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W, STANFORD BLALOCK, MD, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2015-06-30",
        "status": "A",
        "authorized_official_last_name": "BLALOCK",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "STANFORD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "931-906-9860",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TN",
            "license": "16583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vital Chiropractic LLC
• Vitality Sport and Rehab LLC
• Nicholas Vlasnik, DMD
• Volunteer Dental LLC
• Vydrive LLC
• Tonya Wacker, LPCC
• Breonna Irie Wade
• Shaeleina Rae Wade
• Tiffany Lynn Wade
• Kelsey Waggoner, B.S.

• Specialist in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Specialist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2015; 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.