Provider Demographics
NPI:1922091826
Name:BLOW, ALTON JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:ALTON
Middle Name:JOSEPH
Last Name:BLOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:349 ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:VA
Mailing Address - Zip Code:24201-7009
Mailing Address - Country:US
Mailing Address - Phone:276-469-4200
Mailing Address - Fax:276-469-4249
Practice Address - Street 1:349 ISLAND RD
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:VA
Practice Address - Zip Code:24201-7009
Practice Address - Country:US
Practice Address - Phone:276-469-4200
Practice Address - Fax:276-469-4249
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000038381207RH0003X
VA0101043411207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3896585Medicaid
TNB75109Medicare UPIN
TN103I900362Medicare PIN
TN389685Medicare PIN
TN103I902925Medicare PIN
VAVVB265BMedicare PIN