Blandford, Jill Marie
Blandford, Jill Marie is an individual health care provider with primary practice located at 2095 Henry Tecklenburg Dr , Charleston SC 29414-5733. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Neurology is her primary health care specialty. Blandford, Jill Marie can be contacted via phone (843) 402-5035.Contact Information
Primary practice address
2095 Henry Tecklenburg Dr
Charleston SC 29414-5733
Phone: (843) 402-5035
Fax: (843) 402-5036
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 03684 | Kentucky |
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 03684 | Kentucky |
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 1270 | South Carolina |
Profile Details
| NPI number | 1164650123 |
|---|---|
| LBN Legal business name | Blandford, Jill Marie |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 29th, 2009 |
| Last updated | Jul 11th, 2022 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164650123 | NPPES |
| Kentucky | Other | 170948 | SIHO - NNS |
| Kentucky | MEDICAID | 201392140 | SIHO - NNS |
| Kentucky | Other | 000001036470 | SIHO - NNS |
| Kentucky | Other | 50114236 | SIHO - NNS |
| Kentucky | MEDICAID | 7100321110 | SIHO - NNS |
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