David M Blaske, PHD
Individual provider Active NPI Psychologist · Jonesboro, AR
NPI 1790733947 · NPPES record last updated Dec 3, 2009
Key facts
- NPI
- 1790733947
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- 92-15P (AR)
- Practice address
- 2707 Browns Lane
Jonesboro, AR 72401 - Phone
- (870) 972-4939
- Fax
- (870) 972-4911
- NPI assigned
- May 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arkansas Children'S Medical Group PLLC | Past | Accepting new patients | |
| Arkansas Children'S Medical Group PLLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 92-15P | AR | Yes |
Addresses
Primary practice location
2707 Browns Lane
Jonesboro, AR 72401
Mailing address
2707 Browns Lane
Jonesboro, AR 72401
Phone (870) 972-4939
Other providers in Jonesboro, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 3, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.