Provider Demographics
NPI:1285688366
Name:BLATCHFORD, STEVEN J (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:J
Last Name:BLATCHFORD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1775 W SAINT MARYS RD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-2696
Mailing Address - Country:US
Mailing Address - Phone:520-792-2170
Mailing Address - Fax:520-792-9702
Practice Address - Street 1:1775 W SAINT MARYS RD
Practice Address - Street 2:SUITE 211
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-2696
Practice Address - Country:US
Practice Address - Phone:520-792-2170
Practice Address - Fax:520-792-9702
Is Sole Proprietor?:No
Enumeration Date:2006-05-21
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ15176207Y00000X, 207YX0602X, 2085U0001X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic Allergy
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ265662Medicaid
AZ04WCHYT03Medicare ID - Type Unspecified
AZE96463Medicare UPIN
AZZ118593Medicare PIN