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1295784916

NPI Code Detail

MEDICARE: DR. ERIC E BLOM MD

MEDICARE: DR. ERIC E BLOM MD

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
1	207W00000X	Ophthalmology Physician	43724	CO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P00243931	OTHER	CO	RAILROAD MEDICARE
7	0452890001	OTHER	CO	MEDICARE DMERC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	BL672952	OTHER	CO	ANTHEM
3	CO3724	OTHER	CO	EYEMED EYECARE
5	608436900	OTHER	CO	US DEPT LABOR WORK COMP
6	923384020820	OTHER	CO	EYE SPECIALISTS

General Provider Information

NPI Number	:	1295784916
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC E BLOM MD

Provider Business Mailing Address
First Line	:	3155 N UNION BLVD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-8703
Country	:	US
Telephone Number	:	719-630-3937
Fax Number	:	719-635-3578

Provider Business Practice Location Address
First Line	:	3155 N UNION BLVD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-8703
Country	:	US
Telephone Number	:	719-630-3937
Fax Number	:	719-635-3578

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	08/07/2024

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Directions to “ DR. ERIC E BLOM MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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