Bertha J Blanchard
Neurologist
105 Asbury Cir Suite A
Hattiesburg
, Mississippi 39402-1302
Bertha J Blanchard
Neurologist
105 Asbury Cir Suite A
Hattiesburg
, Mississippi 39402-1302
(601) 296-3508
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About
Features
Specialties
- Neurologist
Languages spoken
- English
Location
First Address
- Bertha J Blanchard
- Po Box 15548
- Hattiesburg, MS
- Zip : 39404-5548
- Fax : (601) 296-3508
- Phone : (601) 268-5222
Second Address
- Bertha J Blanchard
- 105 Asbury Cir Suite A
- Hattiesburg, MS
- Zip : 39402-1302
- Fax : (601) 296-3508
- Phone : (601) 268-5222
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2084N0400X | Neurologist | 11501 | MS |
National Provider Identifier
| NPI | 1043274616 |
|---|---|
| Provider Name | Bertha J Blanchard |
| First Address | Hattiesburg, MS 39404-5548 |
| Second Address | Hattiesburg, MS 39402-1302 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 12/04/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 00111298 | (05) | MS |
| C67465 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.