Blakely, Laura Johnetta

Blakely, Laura Johnetta is an individual health care provider with primary practice located at 5653 Frist Blvd Suite 434, Hermitage TN 37076-2062. She recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as her primary health care specialty. Blakely, Laura Johnetta can be contacted via phone (615) 871-9996.

Contact Information

Primary practice address
5653 Frist Blvd Suite 434 Hermitage TN 37076-2062
Phone: (615) 871-9996
Fax: (615) 871-9661
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 38475 Tennessee

Profile Details

NPI number 1265464499
LBN Legal business name Blakely, Laura Johnetta
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2006
Last updated Feb 27th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265464499 NPPES
Tennessee Other 7820270 AETNA
Tennessee Other 99620 AETNA
Tennessee Other 4087020 AETNA

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