MEDICARE: DR. DAVID L BLANDFORD 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	28077	KY

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

General Provider Information

NPI Number	:	1558367805
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID L BLANDFORD MD

Provider Business Mailing Address
First Line	:	601 PERIMETER DR
Second Line	:	STE 200
City	:	LEXINGTON
State	:	KY
Zip	:	40517-4121
Country	:	US
Telephone Number	:	859-278-9393
Fax Number	:	859-278-0923

Provider Business Practice Location Address
First Line	:	601 PERIMETER DR
Second Line	:	STE 200
City	:	LEXINGTON
State	:	KY
Zip	:	40517-4121
Country	:	US
Telephone Number	:	859-278-9393
Fax Number	:	859-278-0923

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

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	01/21/2016

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