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General NPI Number Information
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NPI Number | 1356434500
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Entity Type | Individual
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Provider Name | BERNADETTE D. BLOUNT M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 02/12/2016
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Provider Practice Location Address
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Address Line | 126 HWY 280
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City | AMERICUS
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State | GA
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Zip | 31719-8645
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Country | US
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Telephone | 229-931-1738
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Fax | 229-931-7148
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Provider Business Mailing Address
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Address Line | 7782 PRESERVATION CT
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City | MIDLAND
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State | GA
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Zip | 31820-3664
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Country | US
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Telephone | 706-562-0612
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | PENDING
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 059603
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License Number State | GA
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