Provider Demographics
NPI:1497346274
Name:BLATCHFORD, INC
Entity Type:Organization
Organization Name:BLATCHFORD, INC
Other - Org Name:CHESTNUT WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:TYSON
Authorized Official - Last Name:BLATCHFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-441-4108
Mailing Address - Street 1:119 E CHESTNUT AVE
Mailing Address - Street 2:
Mailing Address - City:ARKANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67005-2200
Mailing Address - Country:US
Mailing Address - Phone:620-441-4108
Mailing Address - Fax:620-741-5093
Practice Address - Street 1:119 E CHESTNUT AVE
Practice Address - Street 2:
Practice Address - City:ARKANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:67005-2200
Practice Address - Country:US
Practice Address - Phone:620-441-4108
Practice Address - Fax:620-741-5093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-03
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty