Provider Demographics
NPI:1740327477
Name:BLATMAN PAIN CLINIC
Entity type:Organization
Organization Name:BLATMAN PAIN CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HAL
Authorized Official - Middle Name:SAMUEL
Authorized Official - Last Name:BLATMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-956-3200
Mailing Address - Street 1:10653 TECHWOOD CIR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-2833
Mailing Address - Country:US
Mailing Address - Phone:513-956-3200
Mailing Address - Fax:513-956-3202
Practice Address - Street 1:10653 TECHWOOD CIR
Practice Address - Street 2:SUITE 101
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-2833
Practice Address - Country:US
Practice Address - Phone:513-956-3200
Practice Address - Fax:513-956-3202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-04-76322083P0500X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental MedicineGroup - Single Specialty
Not Answered208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000015391OtherBLUE CROSS BLUE SHIELD
OH027364930001OtherMEDICAL MUTUAL
OH47632 03OtherCHOICE CARE
OH0653056Medicaid
OH=========-00OtherBUREAU OF WORKERS' COMP
OHA15167Medicare UPIN
OHBL0515763Medicare ID - Type Unspecified