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NPI Code Detail

MEDICARE: REX BLOCKER M.D.

MEDICARE: REX BLOCKER M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208D00000XGeneral Practice Physician21746SC

General Provider Information

NPI Number : 1023560620
Entity Type Code : Individual
Provider Name (Legal Business Name) : REX BLOCKER M.D.
Provider Business Mailing Address
First Line : 501 GARY HILL RD
Second Line :
City : EDGEFIELD
State : SC
Zip : 29824-4503
Country : US
Telephone Number : 803-637-1500
Fax Number : 803-637-7197
Provider Business Practice Location Address
First Line : 501 GARY HILL RD
Second Line :
City : EDGEFIELD
State : SC
Zip : 29824-4503
Country : US
Telephone Number : 803-637-1500
Fax Number : 803-637-7197
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/29/2016
Last Update Date : 10/29/2016

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