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General NPI Number Information
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NPI Number | 1841668746
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Entity Type | Individual
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Provider Name | DR. GERALD BLAKEY
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Gender | Female
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Dates
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Enumeration Date | 09/09/2015
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Last Update Date | 09/09/2015
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Provider Practice Location Address
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Address Line | 2900 CUMBERLAND MALL SE
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City | ATLANTA
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State | GA
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Zip | 30339-8107
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Country | US
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Telephone | 770-431-1709
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Fax | 770-431-1706
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Provider Business Mailing Address
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Address Line | 2900 CUMBERLAND MALL SE
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City | ATLANTA
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State | GA
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Zip | 30339-8107
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Country | US
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Telephone | 770-431-1709
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Fax | 770-431-1906
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH024133
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH51246
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH15257
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License Number State | MD
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