Waynesha E Blaylock, MD is a medicare enrolled "Pediatrics" physician in Mound Bayou, Mississippi. Her current practice location is
702 Martin Luther King St, Mound Bayou, Mississippi. You can reach out to her office (for appointments etc.) via phone at
(662) 741-8800.
Waynesha E Blaylock is licensed to practice in Mississippi (license number 37144) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1720721178.
Physician's Profile
| Full Name | Waynesha E Blaylock |
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| Gender | Female |
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| Speciality | Pediatrics |
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| Location | 702 Martin Luther King St, Mound Bayou, Mississippi |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1720721178
- Provider Enumeration Date: 04/14/2022
- Last Update Date: 05/29/2026
Medicare PECOS Information:
- PECOS PAC ID: 9537547781
- Enrollment ID: I20220601000449
Medical Identifiers
Medical identifiers for Waynesha E Blaylock such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1720721178 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207R00000X | Internal Medicine | 37144 (Mississippi) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| 208000000X | Pediatrics | 37144 (Mississippi) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Waynesha E Blaylock is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Waynesha E Blaylock, MD 702 Martin Luther King St, Mound Bayou, MS 38762-9314 Ph: () - | Waynesha E Blaylock, MD 702 Martin Luther King St, Mound Bayou, MS 38762-9314 Ph: (662) 741-8800 |
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