Provider Demographics
NPI:1073630059
Name:BLAKELY, CHERRON LAKISHA (MT, CLS)
Entity type:Individual
Prefix:MRS
First Name:CHERRON
Middle Name:LAKISHA
Last Name:BLAKELY
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Gender:F
Credentials:MT, CLS
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Mailing Address - Street 1:652 HATCHEE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31021-0888
Mailing Address - Country:US
Mailing Address - Phone:478-676-3081
Mailing Address - Fax:478-277-2840
Practice Address - Street 1:1826 VETERANS BLVD
Practice Address - Street 2:BLDG 3A, PATHOLOGY AND LABORATORY MEDICINE
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-3620
Practice Address - Country:US
Practice Address - Phone:478-277-2750
Practice Address - Fax:478-277-2840
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MD219139246QM0706X
MD9909695246QM0706X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist