Provider Demographics
NPI:1861141418
Name:BLANCHARD, KAITLYN JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:KAITLYN
Middle Name:JAMES
Last Name:BLANCHARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KAITLYN
Other - Middle Name:ANDERSON
Other - Last Name:JAMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1004 CHAFEE AVE
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30904-5810
Mailing Address - Country:US
Mailing Address - Phone:706-721-6231
Mailing Address - Fax:706-721-7960
Practice Address - Street 1:1004 CHAFEE AVE
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30904-5810
Practice Address - Country:US
Practice Address - Phone:706-721-6231
Practice Address - Fax:706-721-7960
Is Sole Proprietor?:No
Enumeration Date:2022-03-21
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program