MEDICARE: BLANCHARD FAMILY MEDICINE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952325557
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLANCHARD FAMILY MEDICINE

Provider Business Mailing Address
First Line	:	PO BOX 1330
Second Line	:
City	:	NORMAN
State	:	OK
Zip	:	73070-1330
Country	:	US
Telephone Number	:	405-485-9321
Fax Number	:	405-485-3154

Provider Business Practice Location Address
First Line	:	1019 N COUNCIL AVE
Second Line	:	SUITE 1
City	:	BLANCHARD
State	:	OK
Zip	:	73010-8045
Country	:	US
Telephone Number	:	405-485-9321
Fax Number	:	405-485-3154

Authorized Official
Title or Position	:	SR VP, COO
Name	:	GREG L TERRELL
Credential	:
Telephone Number	:	405-307-1000

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	04/20/2012

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Directions to “BLANCHARD FAMILY MEDICINE ” Practice Location

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