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General NPI Number Information
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NPI Number | 1972346500
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Entity Type | Individual
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Provider Name | KELSEY BLALOCK OD
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Gender | Female
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Dates
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Enumeration Date | 06/12/2024
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 5415 WASHINGTON PIKE
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City | KNOXVILLE
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State | TN
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Zip | 37918-7004
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Country | US
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Telephone | 865-217-1010
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Fax |
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Provider Business Mailing Address
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Address Line | 1881 JEWEL SISSON WAY APT 107
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City | KNOXVILLE
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State | TN
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Zip | 37917-1345
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Country | US
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Telephone | 614-292-2020
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TN3977
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License Number State | TN
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