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Contact Information

BILLY K BLAYLOCK III, CCMA OTC
11 BERRYMANS LN
REISTERSTOWN, MD21136-1933
 Phone: 410-800-7324
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopaedic Assistant

246ZX2200X
 

Home Health Aide

374U00000X
Indicates primary specialty

NPI Profile & details for BILLY K BLAYLOCK III · (Male)

NPI # 1316798804
Status Active
Credentials CCMA OTC
Entity Individual
Enumeration date 04/01/2024
Last updated 04/01/2024 - About 2 years ago
Sole proprietor 1 Yes
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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