Robert C. Blaylock, MD
Pathology, Blood Banking & Transfusion Medicine in Salt Lake City, UT. Individual provider (NPI-1).
NPI number1104916733
StatusActive
Last updated in NPPESJan 20, 2023
Details
- NPI
- 1104916733
- Entity type
- Individual (NPI-1)
- Name
- Robert C. Blaylock
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 13, 2006
- Certification date
- Jan 20, 2023
- Last updated
- Jan 20, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207ZB0001X | Pathology, Blood Banking & Transfusion Medicine | 177516-1205 | UT | Yes |
| 207ZP0105X | Pathology, Clinical Pathology/Laboratory Medicine | 177516-1205 | UT |
Practice location
50 N Medical DrSalt Lake City, UT 84132-0001
Phone 801-581-2507
Mailing address
Po Box 581054Salt Lake City, UT 84158-1054
Phone 801-213-3800
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