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DR. EDDYE BLOSSOM II MD
NPI 1003028762
Obstetrics & Gynecology in Monroe, LA

Active since May 04, 2007
4864 JACKSON ST, MONROE, LA 71202(318) 330-7626(318) 330-7648 Get Directions Write a Review

NPPES record last updated: January 24, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Eddye Blossom Ii Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. EDDYE BLOSSOM II MD (NPI 1003028762) is an individual obstetrics & gynecology provider in Monroe, Louisiana, licensed in Louisiana (MD.204270) and active in the NPI registry since May 2007.

NPPES Registry Identity

NPI1003028762
Entity TypeIndividualMale
Primary Taxonomy207V00000X
Provider Legal NameDR. EDDYE BLOSSOM IICredential: MD
Location Address4864 JACKSON STMonroe, LA 71202-6400
Mailing Address4864 Jackson StMonroe, LA 71202-6400 · (318) 330-7626 · Fax (318) 330-7648
Phone(318) 330-7626
Fax(318) 330-7648
Sole ProprietorNo
Enumeration DateMay 4, 2007
Last NPPES UpdateJanuary 24, 2013
✔ NPI 1003028762 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
Licenses✔ Licensed in LA · MD.204270✔ Licensed in AR · E-6247✔ Licensed in TN · 45438
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
4864 JACKSON ST, Monroe, LA 71202
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Other Identifiers 1

Medicaid2138014LA

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MISS KANDICE NICOLE HUNTER APRN, AGNP
Nurse Practitioner
4864 JACKSON ST
MONROE, LA 71202
Ouachita Parish (318) 330-7000
HARNOOR SANDHU
Student in an Organized Health Care Education/Training Program
4864 JACKSON ST
MONROE, LA 71202
Ouachita Parish (318) 330-7600
JEFFERY FULLER M.D.
Emergency Medicine
4864 JACKSON ST, DEPARTMENT OF EMERGENCY MEDICAL SERVICES
MONROE, LA 71202
Ouachita Parish (318) 675-7737
DR. WILLIAM TODD YATES MD
Family Medicine
4864 JACKSON ST
MONROE, LA 71202
Ouachita Parish (318) 330-7626
SHANKAR NADESAN MD
Student in an Organized Health Care Education/Training Program
4864 JACKSON ST, DEPT. OF FAMILY MEDICINE
MONROE, LA 71202
Ouachita Parish (318) 330-7615
ANN MARIE CLACK WHNP
Nurse Practitioner (Women's Health)
4864 JACKSON ST
MONROE, LA 71202
Ouachita Parish (318) 330-7000
MR. JONATHAN D BREWER PA
Physician Assistant (Medical)
4864 JACKSON ST
MONROE, LA 71202
Ouachita Parish (318) 330-7626
CALEY WORLEY
Nurse Anesthetist, Certified Registered
4864 JACKSON ST
MONROE, LA 71202
Ouachita Parish (318) 626-0000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Eddye Blossom's NPI number?

The NPI number for Eddye Blossom is 1003028762. It was assigned to this individual provider in the NPPES registry on May 4, 2007.

Where is Eddye Blossom located?

Eddye Blossom practices at 4864 Jackson St, Monroe, LA 71202. The listed phone number is (318) 330-7626.

What is Eddye Blossom's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

When was this NPI record last updated?

The NPPES record for Eddye Blossom was last updated on January 24, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.