Provider Demographics
NPI:1205948692
Name:BLOUNT, JOHN JUSTIN (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:JUSTIN
Last Name:BLOUNT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2700 N CENTRAL AVE STE 1050
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85004-1217
Mailing Address - Country:US
Mailing Address - Phone:602-266-8402
Mailing Address - Fax:
Practice Address - Street 1:1840 N 95TH AVE STE 132
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-4445
Practice Address - Country:US
Practice Address - Phone:623-932-6950
Practice Address - Fax:623-872-6091
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2021-09-22
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Provider Licenses
StateLicense IDTaxonomies
AZ467432084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry