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General NPI Number Information
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NPI Number | 1730906348
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Entity Type | Organization
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Legal Business Name | BLANE CLINICAL LLC
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Dates
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Enumeration Date | 09/24/2024
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 1307 DONELSON PKWY
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City | DOVER
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State | TN
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Zip | 37058-3724
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Country | US
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Telephone | 931-232-0123
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Fax | 931-232-1185
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Provider Business Mailing Address
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Address Line | 1307 DONELSON PKWY
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City | DOVER
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State | TN
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Zip | 37058-3724
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Country | US
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Telephone | 931-232-0123
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Fax | 931-232-1185
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Authorized Official
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Title or Position | AO
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Name | MARLIN BLANE
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Credential |
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Telephone | 312-820-1126
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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