BLAIR MOYLE JOLLEY DPM NPI 1366737728

NPI Information

NPI: 1366737728
Provider Name: BLAIR MOYLE JOLLEY, DPM
Classification: Podiatrist - 213ES0103X
Entity Type: Individual

Specialization: Foot & Ankle Surgery

PECOS Registration: Yes

Address:
13652 CANTARA ST
PANORAMA CITY, CA
ZIP 91402
Phone: (818) 375-2000
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Blair Moyle Jolley, DPM is a foot and ankle surgery podiatrist in Panorama City, CA with 13 years of experience. Blair Moyle Jolley, DPM NPI is 1366737728. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: TEMPLE UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2011

The provider's business location address is:

13652 CANTARA ST
PANORAMA CITY, CA
ZIP 91402-423
Phone: (818) 375-2000
Fax: (818) 375-3201

The NPI 1366737728 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 6/14/2011 and was last updated on 12/1/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213ES0103X	Podiatrist	Foot & Ankle Surgery	E5135	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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