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DR. JERRY D BLAYLOCK M.D.
NPI 1922038975
Counselor - Mental Health in Jonesboro, AR

Active since July 04, 2006
901 S CHURCH ST, JONESBORO, AR 72401(870) 935-0360(870) 972-8603 Get Directions Write a Review

NPPES record last updated: September 22, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Jerry D Blaylock M.d. NPPES

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

DR. JERRY D BLAYLOCK M.D. (NPI 1922038975) is an individual mental health provider in Jonesboro, Arkansas, licensed in Arkansas (C4264) and active in the NPI registry since July 2006.

NPPES Registry Identity

NPI1922038975
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameDR. JERRY D BLAYLOCKCredential: M.D.
Location Address901 S CHURCH STJonesboro, AR 72401-4105
Mailing Address901 S Church StJonesboro, AR 72401-4105 · (870) 935-0360 · Fax (870) 972-8603
Phone(870) 935-0360
Fax(870) 972-8603
Sole ProprietorYes
Enumeration DateJuly 4, 2006
Last NPPES UpdateSeptember 22, 2011
✔ NPI 1922038975 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in AR · C4264
901 S CHURCH ST, Jonesboro, AR 72401
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Other Identifiers 3

Medicare PIN50529AR
Medicare UPIND04371AR
Medicaid101644001AR

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 Jerry Blaylock's NPI number?

The NPI number for Jerry Blaylock is 1922038975. It was assigned to this individual provider in the NPPES registry on July 4, 2006.

Where is Jerry Blaylock located?

Jerry Blaylock practices at 901 S Church St, Jonesboro, AR 72401. The listed phone number is (870) 935-0360.

What is Jerry Blaylock's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Jerry Blaylock was last updated on September 22, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.