John B Blalock Jr.
Surgery

Address: 2660 10th Ave S, Suite 238, Birmingham, AL 35205-1605
Phone: 2059337301

John B Blalock Jr. (NPI# 1063685352) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1063685352
Entity Type Individual
Full Name John B Blalock Jr.
Credential M.D.
Gender Male
Practice Address 2660 10th Ave S
Suite 238
Birmingham
AL 35205-1605
Practice Telephone 2059337301
Mailing Address 2660 10th Ave S
Suite 238
Birmingham
AL 35205-1605
Mailing Telephone 2059337301
Sole Proprietor Yes, this individual is a Sole Proprietor
Enumeration Date 2008-04-08
Last Update Date 2010-05-25

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 208600000X Surgery Allopathic & Osteopathic Physicians 9169 AL

Other Provider Identifier

State Identifier Issuer Type Code
AL 000087171 MEDICAID

Other Providers JOHN BLALOCK

NPI Name Taxonomy Address Enumeration
1184755142 John Michael Blalock Chiropractor 4615 Hampton Ave., St. Louis, MO 63109-2715 2007-03-08
1003862731 John S. Blalock Dentist 3606 Wheeler Rd., Augusta, GA 30909 2006-05-25
1679963185 John Waylan Blalock Chiropractor 523 Main St, El Segundo, CA 90245-3006 2015-02-04

Physician Overview

NPI 1063685352
PAC ID by PECOS 7113075805
Professional Enrollment ID I20180828001197
Full Name John B Blalock
Organization Legal Name CENTRA MEDICAL GROUP, LLC
Phone Number 4342003933
Gender M
Medical School UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE
Graduation Year 1975
Primary Specialty GENERAL SURGERY
Group Practice PAC ID 4789606088
Number of Group Practice Members 467
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
490021 CENTRA

Office Location

Street Address 2660 10TH AVE S
SUITE 238
City BIRMINGHAM
State AL
Zip Code 35205-1605

Providers in the same location

NPI Name Taxonomy Address Enumeration
1164421129 Roy Francis Stanton, IIi Internal Medicine 2660 10th Ave S, Suite 401, Birmingham, AL 35205-1605 2005-07-20
1073974556 Shelley Moreland Nurse Practitioner 2660 10th Ave S, #610, Birmingham, AL 35205-1605 2016-03-11
1265893002 Alabama Digestive Diseases PC Clinic/Center 2660 10th Ave S, #610, Birmingham, AL 35205-1605 2016-03-07
1154738771 Ashleigh Reimann Nurse Practitioner 2660 10th Ave S, Suite 528, Birmingham, AL 35205-1605 2014-07-15
1700214939 Jane Pearson Md Pa Preferred Provider Organization 2660 10th Ave S, Birmingham, AL 35205-1605 2013-10-25
1669809943 Laura Grace Jones Nurse Practitioner 2660 10th Ave S, Pob 1, Suite 107, Birmingham, AL 35205-1605 2013-10-02
1871925909 Vnss Sailaja Radha Ramani Varanasi Student in an Organized Health Care Education/Training Program 2660 10th Ave S, Pob 1, Suite 720, Birmingham, AL 35205-1605 2013-07-31
1952656001 Jose Manuel Rodriguez-barrantes Family Medicine 2660 10th Ave S, Professional Building 1, Suite 720, Birmingham, AL 35205-1605 2012-07-16
1306111307 Over The Mountain Rehab, Inc Occupational Therapist 2660 10th Ave S, Suite 707, Birmingham, AL 35205-1605 2012-03-09
1063721926 Anesthesia Services At Vascular Institute Nurse Anesthetist, Certified Registered 2660 10th Ave S, Pob #1, Suite 608 Room B, Birmingham, AL 35205-1605 2010-09-27
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1124547674 Serve Home Health Care Agency, LLC In Home Supportive Care 2230 Green Springs Hwy S, Birmingham, AL 35205 2017-09-15
1457870487 Marilyn Bennett Pinson Pharmacist Walgreens Store #15144, 3020 Clairmont Ave S, Birmingham, AL 35205 2017-09-11
1639522238 Dana Rives Speech-Language Pathologist St. Vincent's, Building 3, Suite 402, Birmingham, AL 35205 2016-07-19
1760854236 Raymond Herring Chiropractor 1226 29th St S, Apt 18, Birmingham, AL 35205 2015-10-23
1083005813 Absolutely Amazing Salon Prosthetic/Orthotic Supplier 2227 Arlington Avenue, Birmingham, AL 35205 2015-02-16
1396141651 Alexandria Hutchison Occupational Therapist 833 Saint Vincent's Drive, Building 3, Suite 200, Birmingham, AL 35205 2014-11-14
1790028199 Patrick Ross Owens Otolaryngology 833 Saint Vincents Dr Ste 402, Birmingham, AL 35205 2013-04-03
1053657452 David Mitchell Comfort Urology 2716 Hanover Circle, Unit 801, Birmingham, AL 35205 2012-12-13
1598023632 Kathryn Ashley Bentley Orthopaedic Surgery 833 St. Vincent's Drive, Bldg 3, Ste 403, Birmingham, AL 35205 2012-04-26
1114298510 Natalie Elizabeth George Physician Assistant 2100 16th Avenue South, 202, Birmingham, AL 35205 2012-01-18
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Taxonomy Information

Taxonomy Code 208600000X
Grouping Allopathic & Osteopathic Physicians
Classification Surgery

Taxonomy Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1528413051 Vinh Nguyen Md PC Surgery 100 Pilot Medical Dr Ste 285, Birmingham, AL 35235-3475 2016-05-03
1619315918 William Foster Gaillard Jr. Surgery 1808 7th Avenue South, Bdb 503, Birmingham, AL 35294 2013-06-07
1720350424 William Nathan Viar Jr. Surgery 3824 Forest Glen Dr., Birmingham, AL 35213 2012-01-27
1225306129 Thomas Wakefield Mears Surgery 2324 Brookshire Place, Birmingham, AL 35213 2011-12-06
1902124217 Lauren Caldwell Tanner Surgery 1922 7th Avenue South, Kb110, Birmingham, AL 35294 2010-05-11
1700012309 Cameron S. Askew Surgery 513 Brookwood Medical Plaza, Suite 310, Birmingham, AL 35209-6804 2009-06-09
1235321274 George Panayiotis Hatzigeorgis Surgery 1617 11th Ave S, Birmingham, AL 35205 2007-08-14
1427256163 James E Mace Jr. Surgery 625 19th St S, Birmingham, AL 35249 2007-07-04
1003011859 Melanie Sanders Morris Surgery Uab Surgery Gi Section, 1922 7th Ave S 406 Kracke Bldg, Birmingham, AL 35294-0001 2007-06-20
1184792897 George P Hatzigeorgis Professional Association Surgery 1617 11th Avenue South, Birmingham, AL 35205 2006-12-01
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Competitor

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City BIRMINGHAM
Zip Code 35205

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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