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General NPI Number Information
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NPI Number | 1134147853
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Entity Type | Individual
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Provider Name | LUCIUS BLANCHARD MD
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Gender | Male
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 4488 S PECOS RD
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City | LAS VEGAS
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State | NV
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Zip | 89121-5030
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Country | US
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Telephone | 702-436-1001
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Fax | 702-436-7999
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Provider Business Mailing Address
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Address Line | 9900 N CENTRAL EXPY STE 500
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City | DALLAS
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State | TX
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Zip | 75231-0928
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Country | US
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Telephone | 702-360-2100
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Fax | 949-783-2880
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number | 3617
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License Number State | NV
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