| Dr Travis Wayne Blalock, MD | |
|
619 Ne 13th St, Oklahoma City, OK 73104-5001 | |
| (405) 271-6110 | |
| Not Available |
| Full Name | Dr Travis Wayne Blalock |
|---|---|
| Gender | Male |
| Speciality | Dermatology |
| Experience | 18 Years |
| Location | 619 Ne 13th St, Oklahoma City, Oklahoma |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710195003 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207ND0101X | Dermatology - Mohs-micrographic Surgery | 73100 (Georgia) | Primary |
| 207NS0135X | Dermatology - Procedural Dermatology | A116875 (California) | Secondary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| The Emory Clinic Inc | 8820901408 | 3084 |
| Entity Name | The Emory Clinic Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1396798229 PECOS PAC ID: 8820901408 Enrollment ID: O20031110000503 |
| Entity Name | Emory Medical Care Foundation Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063452381 PECOS PAC ID: 4981501814 Enrollment ID: O20031217000968 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Travis Wayne Blalock, MD 1525 Clifton Rd Ne Ste 112a, Atlanta, GA 30322-4200 Ph: (404) 778-3333 | Dr Travis Wayne Blalock, MD 619 Ne 13th St, Oklahoma City, OK 73104-5001 Ph: (405) 271-6110 |
Jason Matthew Hirshburg, M.D. PH.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 7336 N Classen Blvd Ste 200, Oklahoma City, OK 73116 Phone: 405-285-8823 Fax: 405-285-8824 | |
Dr. Carlos Andres Garcia, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 4805 S Western Ave, Oklahoma City, OK 73109 Phone: 405-636-1506 Fax: 405-636-1511 | |
Francesca L Veon, DO Dermatology Medicare: Medicare Enrolled Practice Location: 1000 Ne 13th St # 3960, Oklahoma City, OK 73104 Phone: 405-271-6110 | |
Mark Stover Sullivan, MD Dermatology Medicare: Not Enrolled in Medicare Practice Location: 3366 Nw Expressway, Suite 720, Oklahoma City, OK 73112 Phone: 405-947-0676 Fax: 405-945-4876 | |
Dr. Brandon Rhinehart, D.O. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 13100 N Western, Ste 301, Oklahoma City, OK 73114 Phone: 405-947-6647 Fax: 405-948-6647 | |
Marlee Michele Wimberley, MD Dermatology Medicare: Not Enrolled in Medicare Practice Location: 1000 Ne 13th St # 3960, Oklahoma City, OK 73104 Phone: 405-271-6110 | |
Mark A Dawkins, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 13174 N Macarthur Blvd, Oklahoma City, OK 73142 Phone: 405-721-5555 Fax: 405-470-7093 |