Provider Demographics
NPI:1740459817
Name:ADRAIN B. BLOTNER MD PC
Entity type:Organization
Organization Name:ADRAIN B. BLOTNER MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADRIAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:BLOTNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-761-3255
Mailing Address - Street 1:PO BOX 1000 DEPT 217
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38148-0001
Mailing Address - Country:US
Mailing Address - Phone:901-758-8145
Mailing Address - Fax:901-309-8784
Practice Address - Street 1:6401 POPLAR AVE STE 316
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-4806
Practice Address - Country:US
Practice Address - Phone:901-761-3255
Practice Address - Fax:901-309-8784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-22
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty